Individual
ERWIN INCIONG DIMACULANGAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
655 S LINCOLN ST, DIXON, CA 95620-9419
(650) 892-1842
Mailing address
655 S LINCOLN ST, DIXON, CA 95620-9419
(650) 892-1842
Taxonomy
Speciality
Code
Description
License number
State
164X00000X
Licensed Vocational Nurse
Primary
291339
CA
Other
Enumeration date
07/04/2023
Last updated
07/04/2023
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