Individual
AMANDA VAN LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
584 N SUNRISE AVE STE 100, ROSEVILLE, CA 95661-2862
(916) 250-2596
(916) 550-5025
Mailing address
1625 CREEKSIDE DR STE 202, FOLSOM, CA 95630-3819
(916) 663-2100
(916) 663-2103
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
5101024118
MI
Other
Enumeration date
07/03/2018
Last updated
07/21/2023
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