Individual
CLEMENTINE S ODAMTTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2498 STEVENS CREEK BLVD, SAN JOSE, CA 95128-1652
(408) 998-5400
(408) 998-5414
Mailing address
308 SHAUGHNESSY DR, MILPITAS, CA 95035-5474
(571) 524-6265
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
95006909
CA
Other
Enumeration date
07/28/2017
Last updated
07/28/2017
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