Individual
DANIELA PEROUTKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3100 DOUGLAS BLVD, ROSEVILLE, CA 95661-3866
(916) 774-8300
(916) 772-5245
Mailing address
10470 OLD PLACERVILLE RD, SUITE 100, SACRAMENTO, CA 95827-2539
(855) 771-0335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A52417
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A524170
—
CA
Enumeration date
09/15/2006
Last updated
07/10/2015
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