Individual
MAXIME KONAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1350 HAYES ST STE C4, BENICIA, CA 94510-2969
(510) 692-1804
Mailing address
1350 HAYES ST STE C4, BENICIA, CA 94510-2969
(510) 692-1804
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
35945
PUBLIC UTILITIES COMMISSION OF THE STATE OF CALIFORNIA
CA
Enumeration date
06/18/2016
Last updated
06/18/2016
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