Individual
JUSTIN DEFFEBACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2755 HERNDON AVE, CLOVIS, CA 93611-6800
(559) 324-4000
Mailing address
3148 N BRIDLE AVE, FRESNO, CA 93727-9115
(559) 720-8026
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
95134058
CA
Other
Enumeration date
11/04/2024
Last updated
11/04/2024
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