Organization
ONSITE PRIMARY CARE AND NURSING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DESALEGN EJIGU NURSE PRACTITIONER (PRESIDENT/NURSE PRACTITIONER)
(408) 387-3269
Entity
Organization
Contact information
Practice address
678 3RD ST, WOODLAND, CA 95695-4034
(408) 387-3269
Mailing address
5665 AMNEST WAY, SACRAMENTO, CA 95835-1928
(408) 387-3269
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
—
—
Other
Enumeration date
03/03/2020
Last updated
04/16/2020
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