Individual
TRACIE WATSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
500 LENNON LN, WALNUT CREEK, CA 94598-2415
(925) 939-9610
(925) 939-9630
Mailing address
500 LENNON LN, WALNUT CREEK, CA 94598-2415
(925) 939-9610
(925) 939-9630
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
BF4649604-B213
IL
207RH0003X
Hematology & Oncology Physician
Primary
20A18558
CA
208000000X
Pediatrics Physician
BF4649604-B213
IL
Other
Enumeration date
03/21/2013
Last updated
01/15/2021
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