Individual
PAUL VISCOGLIOSI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
3883 AIRWAY DR STE 165, SANTA ROSA, CA 95403-1675
(707) 521-7799
(707) 573-5431
Mailing address
213 CHRIS ST, WINDSOR, CA 95492-8631
(925) 381-3790
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
55373
CA
363AS0400X
Surgical Physician Assistant
55373
CA
Other
Enumeration date
03/12/2018
Last updated
03/17/2018
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