Individual
CHRISTOPHER ROBERT FOSSACECA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2151 W GRANT LINE RD, TRACY, CA 95377-7309
(209) 832-0535
Mailing address
600 COFFEE RD, MODESTO, CA 95355-4201
(209) 521-6097
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
A113247
CA
207L00000X
Anesthesiology Physician
ML20008774
WA
Other
Enumeration date
10/20/2006
Last updated
08/28/2013
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