Individual
ELLEN HADDOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3200 KEARNEY ST, FREMONT, CA 94538-2299
(510) 498-2374
Mailing address
PO BOX 276950, SACRAMENTO, CA 95827-6950
(510) 498-2374
(415) 499-0290
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
A157683
CA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/01/2017
Last updated
11/18/2024
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