Individual
DEBARSHI DATTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1441 FLORIDA AVE, MODESTO, CA 95350-4404
(209) 576-3613
Mailing address
1145 VAUXHALL AVE, GALT, CA 95632-3179
Taxonomy
Speciality
Code
Description
License number
State
242T00000X
Perfusionist
Primary
—
—
Other
Enumeration date
10/09/2015
Last updated
10/09/2015
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