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Organization
WANDISAN AND ROSETE MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization
WANDISAN AND ROSETE MEDICAL GROUP PROFESSIONAL CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FLORENCE WANDISAN ROSETE M.D (CFO)
(209) 836-4920
Entity
Organization
Contact information
Practice address
4600 S TRACY BLVD #107, TRACY, CA 95377
(209) 836-4920
(209) 836-4935
Mailing address
4600 S TRACY BLVD #107, TRACY, CA 95377
(209) 836-4920
(209) 836-4935
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
A72169
CA
Other
Enumeration date
08/31/2006
Last updated
07/10/2018
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