Individual
DR. FIDEL REALYVASQUEZ JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 BUSINESS PARK WAY STE 111, SACRAMENTO, CA 95828-0959
(916) 387-6929
(916) 387-6977
Mailing address
15 BUSINESS PARK WAY STE 111, SACRAMENTO, CA 95828-0959
(916) 387-6929
(916) 387-6977
Taxonomy
Speciality
Code
Description
License number
State
2083X0100X
Occupational Medicine Physician
Primary
G33283
CA
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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