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Individual

DR. GLEN C JICKLING

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2805 50TH ST, RM 2415, MIND INSTITUTE, UNIVERSITY OF CALIFORNIA DAVIS, SACRAMENTO, CA 95817-2312
(916) 703-0449
Mailing address
2805 50TH ST, RM 2415, MIND INSTITUTE, UNIVERSITY OF CALIFORNIA DAVIS, SACRAMENTO, CA 95817-2312
(916) 703-0449

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
A104529
CA

Other

Enumeration date
05/02/2013
Last updated
05/02/2013
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