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Individual

DR. JACK EDWARD LAMENDOLA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
7248 S LAND PARK DR, SUITE 113, SACRAMENTO, CA 95831-3660
(916) 395-5226
(916) 399-1569
Mailing address
7248 S LAND PARK DR, SUITE 113, SACRAMENTO, CA 95831-3660
(916) 395-5226
(916) 399-1569

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
00A37053
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00A370531
CA
Enumeration date
07/10/2006
Last updated
07/09/2007
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