Individual
DR. DONALD J CLUTTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1561 CREEKSIDE DR STE 180, FOLSOM, CA 95630-3495
(916) 984-8830
(916) 984-8834
Mailing address
1111 EXPOSITION BLVD BLDG 700, SACRAMENTO, CA 95815-4314
(916) 736-3399
(916) 233-4171
Taxonomy
Speciality
Code
Description
License number
State
207YS0123X
Facial Plastic Surgery Physician
C40784
CA
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
C40784
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040007824
RR MEDICARE PIN
CA
Enumeration date
05/24/2005
Last updated
10/30/2020
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