Individual
CHARLES VINCENT PANADERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4250 AUBURN BLVD, SACRAMENTO, CA 95841-4100
(916) 489-3336
Mailing address
PO BOX 1956, ROCKLIN, CA 95677-7956
(916) 761-4668
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
A77796
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A777960
—
CA
Enumeration date
12/13/2005
Last updated
09/07/2007
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