Organization
DAEMEN MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINDA BOUCHARD (GYNECOLOGY)
(209) 824-2202
Entity
Organization
Contact information
Practice address
295 MCNARY CIRCLE, MANTECA, CA 95336
(209) 824-2202
Mailing address
295 MCNARY CIRCLE, MANTECA, CA 95336
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
G58369
CA
Other
Enumeration date
05/17/2007
Last updated
08/22/2020
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