Individual
MARK DERASMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7342
Mailing address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-7342
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
30410
MS
Other
Enumeration date
04/07/2020
Last updated
07/21/2025
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