Individual
ANITA VASUDEVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
652 PETALUMA AVE STE H, SEBASTOPOL, CA 95472-4266
(707) 823-3166
(707) 869-8171
Mailing address
PO BOX 1449, GUERNEVILLE, CA 95446-1449
(077) 869-5977
(707) 869-5983
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A186837
CA
Other
Enumeration date
03/23/2020
Last updated
03/20/2024
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