Individual
BIRHANU Z. ADMASSIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2122 W KETTLEMAN LN, LODI, CA 95242
(209) 224-8517
Mailing address
4059 LOST CANYON COURT, HOUSE, ANTIOCH, CA 94531
(925) 779-1982
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
95009185
CA
Other
Enumeration date
10/05/2018
Last updated
10/05/2018
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