Individual
DMITRIY VLADIMIROVICH BAZARON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CNP
Contact information
Practice address
3234 MARYSVILLE BLVD, SACRAMENTO, CA 95815-1411
(916) 454-2345
Mailing address
1860 HOWE AVE STE 440, SACRAMENTO, CA 95825-1098
(916) 569-8484
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
95030783
CA
Other
Enumeration date
01/22/2018
Last updated
08/29/2025
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