Individual
DR. MICHAEL RICHARD VALLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1617 BROADWAY ST, VALLEJO, CA 94590-2406
(707) 556-3794
Mailing address
399 KING RD, PETALUMA, CA 94952-1008
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
G069087
CA
Other
Enumeration date
10/27/2006
Last updated
12/17/2021
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