Individual
MR. MICHAEL SPENCER TRACY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C.R.N.A.
Contact information
Practice address
975 SERENO DR, VALLEJO, CA 94589-2485
(707) 651-1000
Mailing address
975 SERENO DR, VALLEJO, CA 94589-2441
(707) 651-3884
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN261239
CA
Other
Enumeration date
12/26/2006
Last updated
07/08/2007
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