Individual
AL KHAN CABANEZ ALSUA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2185 W GRANT LINE RD, TRACY MEDICAL OFFICES, TRACY, CA 95377-7309
(209) 839-3200
Mailing address
7373 WEST LN, TPMG PHYSICIAN ADMINISTRATION, STOCKTON, CA 95210-3377
(209) 476-3484
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A118497
CA
Other
Enumeration date
04/06/2009
Last updated
12/15/2021
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