Individual
ANDREW WILLIAM LA BRUCHERIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1800 N CALIFORNIA ST, STOCKTON, CA 95204-6019
(209) 943-2000
Mailing address
3804 LARK HAVEN CT, STOCKTON, CA 95219-2550
(760) 791-6679
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
95072796
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
95001813
CA
Other
Enumeration date
05/27/2022
Last updated
07/07/2022
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