Individual
MAX AMERICAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
101 BODIN CIR, TRAVIS AFB, CA 94535-1809
(707) 423-3000
Mailing address
PO BOX 3528, FAIRFIELD, CA 94533-0528
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101277036
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2015
Last updated
11/08/2022
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