Organization
PHYSICIANS NETWORK MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID ORMEROD (MD/CEO)
(916) 789-4209
Entity
Organization
Contact information
Practice address
2100 DOUGLAS BLVD, ROSEVILLE, CA 95661-3804
(916) 789-4209
(916) 789-4206
Mailing address
2100 DOUGLAS BLVD, ROSEVILLE, CA 95661-3804
(916) 789-4209
(916) 789-4206
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
12/07/2011
Last updated
12/07/2011
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