Individual
JONATHAN DAVID PACKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
5 MEDICAL PLAZA DR STE 190, ROSEVILLE, CA 95661-2867
(916) 679-3590
Mailing address
1300 ETHAN WAY STE 600, SACRAMENTO, CA 95825-2296
(916) 679-3590
(916) 482-3647
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
20A21007
CA
207RP1001X
Pulmonary Disease Physician
Primary
20A21007
CA
Other
Enumeration date
04/24/2017
Last updated
07/14/2023
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