Individual
ELAINE MANANSALA GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
425 UNIVERSITY AVE, SUITE 200, SACRAMENTO, CA 95825
(916) 924-9337
(916) 924-8281
Mailing address
425 UNIVERSITY AVE, SUITE 200, SACRAMENTO, CA 95825
(916) 924-9337
(916) 924-8281
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
438698
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
438698
LICENSE NUMBER
CA
01
—
7230
FURNISHING NUMBER
CA
Enumeration date
04/12/2007
Last updated
07/08/2007
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