Individual
STELLA DETARSIO-PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1 RIO VISTA AVE, OAKLAND, CA 94611-5320
(510) 277-7428
Mailing address
2601 BLANDING AVE, C340, ALAMEDA, CA 94501-1579
(510) 277-7428
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
ND463
CA
Other
Enumeration date
04/27/2015
Last updated
04/27/2015
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