Individual
AO DAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2570 48TH ST, SACRAMENTO, CA 95817-1541
(626) 361-9932
Mailing address
151 W MARSHALL ST APT C, SAN GABRIEL, CA 91776-4152
(626) 361-9932
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/28/2025
Last updated
04/28/2025
About Stedi
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