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ANASTASIA P DERTLIEVA-POPOVA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
2575 E BIDWELL ST, SUITE 230, FOLSOM, CA 95630-6444
(916) 984-3899
Mailing address
PO BOX 34120, RENO, NV 89533-4120
(775) 747-5050

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA21114
CA

Other

Enumeration date
09/22/2010
Last updated
09/22/2010
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