Individual
JEFF COULSTON VAN GUNDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2521 STOCKTON BLVD, SACRAMENTO, CA 95817-2207
(916) 734-1461
Mailing address
2516 STOCKTON BLVD, SACRAMENTO, CA 95817-2208
(916) 734-1461
Taxonomy
Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
Primary
C43154
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00C431540
—
CA
Enumeration date
06/27/2006
Last updated
04/24/2014
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