Individual
MARC DAVID IKEDA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6600 BRUCEVILLE RD, MOB 3 - SUITE 233, SACRAMENTO, CA 95823-4671
(916) 627-7500
Mailing address
6600 BRUCEVILLE RD, MOB 3 - SUITE 233, SACRAMENTO, CA 95823-4671
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
A105562
CA
207KA0200X
Allergy Physician
MT200406
PA
208000000X
Pediatrics Physician
A105562
CA
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/26/2008
Last updated
02/11/2022
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