Individual
EUGENE ANDRE MANSOUR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4150 V ST STREET, SUITE 1200, SACRAMENTO, CA 95817-1460
(916) 734-5028
(916) 734-7980
Mailing address
4150 V STREET SUITE 1200, SACRAMENTO, CA 95817-1460
(916) 734-5028
(916) 734-7980
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
F 5816
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F 5816
MD LICENSE 2113
CA
Enumeration date
03/13/2014
Last updated
03/13/2014
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