Organization
DAVID R. GOTHAM, JR., D.O., INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID R GOTHAM JR. D.O. (PRESIDENT)
(916) 616-0510
Entity
Organization
Contact information
Practice address
2204 PLAZA DR, SUITE 210, ROCKLIN, CA 95765-4413
(916) 771-9555
(916) 771-9556
Mailing address
7855 WINGATE CT, GRANITE BAY, CA 95746-9362
(916) 791-9510
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
20A8894
CA
Other
Enumeration date
08/17/2007
Last updated
07/30/2009
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