Organization
ROSEVILLE CARDIOLOGY MEDICAL ASSOCIATES, INC.
Active
Organization
ROSEVILLE CARDIOLOGY MEDICAL ASSOCIATES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID BENNETT WAMPOLD M.D. (PRESIDENT)
(916) 782-2146
Entity
Organization
Contact information
Practice address
2 MEDICAL PLAZA DR, #175, ROSEVILLE, CA 95661-3049
(916) 782-2146
(916) 782-4299
Mailing address
2 MEDICAL PLAZA DR, #175, ROSEVILLE, CA 95661-3049
(916) 782-2146
(916) 782-4299
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A41602
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0094900
—
CA
01
—
ZZZ06970Z
BLUE SHIELD
—
Enumeration date
06/13/2006
Last updated
08/30/2012
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