Individual
GARY A INCAUDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
145 MISSION RANCH BLVD, SUITE 110, CHICO, CA 95926-2175
(530) 896-2200
(530) 896-2209
Mailing address
145 MISSION RANCH BLVD, SUITE 110, CHICO, CA 95926-2175
(530) 896-2200
(530) 896-2209
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
G27753
CA
2080P0201X
Pediatric Allergy/Immunology Physician
G27753
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G277530
—
CA
Enumeration date
07/16/2006
Last updated
01/18/2010
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