Individual
ETIENNE MARIA VASCONCELLOSDE MACEDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4168 FRONT ST, SAN DIEGO, CA 92103-2030
(800) 926-8273
Mailing address
FILE 57326, LOS ANGELES, CA 90074-7326
(858) 249-6748
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
A176287
CA
Other
Enumeration date
09/12/2017
Last updated
10/22/2024
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