Individual
DR. ANDREW RICHARD DE MAR JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 MEDICAL PLAZA DR, SUITE 275, ROSEVILLE, CA 95661-3043
(916) 797-7534
(916) 797-4712
Mailing address
PO BOX 2366, ROCKLIN, CA 95677-8366
(916) 797-7534
(916) 797-4712
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G58869
CA
2086S0102X
Surgical Critical Care Physician
G58869
CA
2086S0127X
Trauma Surgery Physician
G58869
CA
Other
Enumeration date
07/22/2006
Last updated
04/14/2009
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