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Individual

RICHARD DARRELL MCGLOTHLIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.A.

Contact information

Practice address
1501 SECRET RAVINE PARKWAY, UNIT 527, ROSEVILLE, CA 95661-6005
(916) 622-3609
(916) 780-1679
Mailing address
PO BOX 2367, GRANITE BAY, CA 95746-2367
(916) 622-3609
(916) 780-1679

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA19185
CA
363AS0400X
Surgical Physician Assistant
Primary
PA19185
CA

Other

Enumeration date
05/30/2007
Last updated
05/20/2024
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