Organization
CLARION TECHNOLOGY LLC
Active
Other names
Trina Health of Mt. Laurel
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEANE' WALLACE (CREDENTIALING SPECIALIST)
(916) 571-9041
Entity
Organization
Contact information
Practice address
5000 ATRIUM WAY STE 3, MOUNT LAUREL, NJ 08054-3915
(916) 550-1050
Mailing address
4441 AUBURN BLVD STE J, SACRAMENTO, CA 95841-4139
(916) 550-1050
(916) 550-1238
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
Other
Enumeration date
06/23/2017
Last updated
07/18/2017
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