Individual
STACY M LAGOMARSINO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
1600 OWENS ST, SAN FRANCISCO, CA 94158-2261
(415) 833-2000
Mailing address
4601 DALE RD, MODESTO, CA 95356-9718
(209) 735-6102
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA18133
CA
Other
Enumeration date
03/07/2007
Last updated
10/11/2024
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