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Individual

DR. GREGORY EDWARD DOUGLAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
9281 OFFICE PARK CIR, 120, ELK GROVE, CA 95758-8068
(916) 896-1650
(916) 896-1959
Mailing address
9281 OFFICE PARK CIR, 120, ELK GROVE, CA 95758-8068
(916) 896-1650
(916) 896-1959

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
C39164
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00C391640
CA
05
00C391641
CA
Enumeration date
02/13/2006
Last updated
08/07/2013
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