Individual
VICTOR LEE IBARRA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RCP, RRT
Contact information
Practice address
1600 EUREKA RD, ROSEVILLE, CA 95661-3027
(916) 784-4000
Mailing address
11905 ALTA SIERRA DR, GRASS VALLEY, CA 95949-6665
(530) 575-4000
Taxonomy
Speciality
Code
Description
License number
State
2279G1100X
General Care Registered Respiratory Therapist
Primary
6542
CA
Other
Enumeration date
12/11/2018
Last updated
12/11/2018
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