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Individual

DR. DAVID R GOTHAM JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
2204 PLAZA DR, SUITE 210, ROCKLIN, CA 95765-4413
(916) 771-9555
(916) 771-9556
Mailing address
2204 PLAZA DR, SUITE 210, ROCKLIN, CA 95765-4413
(916) 771-9555
(916) 771-9556

Taxonomy

Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
20A8894
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00AX88940
CA
Enumeration date
11/04/2005
Last updated
04/07/2009
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