Individual
CHAMPAK VENKITACHALAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Contact information
Practice address
1020 29TH ST STE 480, SACRAMENTO, CA 95816-5173
(916) 733-3777
Mailing address
10470 OLD PLACERVILLE RD, SACRAMENTO, CA 95827-2539
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
Primary
A122227
CA
Other
Enumeration date
10/03/2010
Last updated
04/09/2019
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