Individual
MRS. ADEPEJU BOLANLE GEORGE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
8233 E STOCKTON BLVD STE D, SACRAMENTO, CA 95828-8203
(916) 368-3080
(916) 405-6551
Mailing address
9999 CORTINO WAY, ELK GROVE, CA 95757-3052
(916) 879-4157
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA17876
CA
363AM0700X
Medical Physician Assistant
Primary
PA17876
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PA17876
—
CA
Enumeration date
12/09/2006
Last updated
11/16/2015
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