Individual
STANLEY C HENJUM II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1004 FOWLER WAY, #4, PLACERVILLE, CA 95667-5746
(530) 626-9488
Mailing address
PO BOX 45680, SAN FRANCISCO, CA 94145-0680
(530) 626-9488
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
G62392
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G623920
—
CA
01
—
90095380
RAILROAD MEDICARE
CA
Enumeration date
01/20/2006
Last updated
01/12/2016
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