Individual
EBTESAM GERGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
4411 4TH AVE APT B, SACRAMENTO, CA 95817-3059
(848) 248-0013
Mailing address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
57267
CA
Other
Enumeration date
08/13/2019
Last updated
10/10/2019
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