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Individual

JOEL MACASERO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
1234 MCHENRY AVE, MODESTO, CA 95350-5373
(209) 409-3199
Mailing address
1234 MCHENRY AVE, MODESTO, CA 95350-5373
(209) 409-3199

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
23830
CA

Other

Enumeration date
12/10/2013
Last updated
03/14/2019
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