Individual
DR. DONALD DUANE VANFOSSAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 CLINTON RD, SUITE 106, JACKSON, CA 95642-2648
(209) 223-3021
Mailing address
19200 MOUNTAIN VIEW WAY, VOLCANO, CA 95689-9707
(209) 296-3163
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
00G577420
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G577420
—
CA
Enumeration date
11/09/2006
Last updated
07/08/2007
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