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Individual

DR. JANE O'GREEN KOENIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
77 CADILLAC DR, SUITE# 130, SACRAMENTO, CA 95825-5453
(916) 929-8564
(916) 929-4529
Mailing address
77 CADILLAC DR, SUITE# 130, SACRAMENTO, CA 95825-5453
(916) 929-8564
(916) 929-4529

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
G38095
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GR0015060
CA
Enumeration date
07/27/2006
Last updated
02/06/2008
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