Individual
DR. GLENN P DAUBERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6900 BRUCEVILLE ROAD, SACRAMENTO, CA 95823
(916) 688-2535
(916) 688-2350
Mailing address
11605 BOOM POINTER WAY, GOLD RIVER, CA 95670-7625
(916) 708-3972
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C52359
CA
207PT0002X
Medical Toxicology (Emergency Medicine) Physician
C52359
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104625314
—
MI
01
—
GD078739
BS/BS OF MICHIGAN
MI
Enumeration date
06/01/2006
Last updated
12/20/2021
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