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Individual

MR. DAVID RUSSELL JANBAZ

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
4860 Y ST, SACRAMENTO, CA 95817-2307
(916) 734-6700
Mailing address
1137 RUDGWICK DR, ROSEVILLE, CA 95747-6453

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT 1786
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
08771
EMPLOEE
CA
Enumeration date
12/20/2005
Last updated
07/08/2007
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