Individual
GLENN SCOTT ADRIANO ROLDAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4220 LEGACY CT, SALIDA, CA 95368-9758
(925) 876-5326
Mailing address
4220 LEGACY CT, SALIDA, CA 95368-9758
(925) 876-5326
Taxonomy
Speciality
Code
Description
License number
State
246ZE0500X
EEG Specialist/Technologist
Primary
450
CA
Other
Enumeration date
09/24/2019
Last updated
09/24/2019
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