Individual
BRIAN VIKSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1020 NUT TREE RD STE 390, VACAVILLE, CA 95687-4100
(707) 624-8001
(707) 624-8001
Mailing address
1020 NUT TREE RD STE 390, VACAVILLE, CA 95687-4100
(707) 624-8000
(707) 624-8001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
A 69795
CA
207RH0003X
Hematology & Oncology Physician
Primary
A69795
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A 69795
MEDICAL LICENSE
CA
Enumeration date
09/14/2006
Last updated
07/08/2022
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