Individual
STEPHEN KOTAREK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
414 G ST STE 221, MARYSVILLE, CA 95901-5670
(916) 733-5090
Mailing address
414 G ST STE 221, MARYSVILLE, CA 95901-5670
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA19292
CA
Other
Enumeration date
03/27/2009
Last updated
11/25/2019
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