Individual
MR. JOHN WESLEY GARDNER IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1080 MARSHALL WAY, MARSHALL HOSPITAL, PLACERVILLE, CA 95667
(530) 622-1441
(530) 622-8655
Mailing address
3441 CARSON RD, CAMINO, CA 95709
(530) 647-9704
(530) 644-8420
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
468480
CA
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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