Individual
GERMAN BADILLA GORDOVE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN, PCCN, AGACNP-BC
Contact information
Practice address
2315 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(916) 734-5590
Mailing address
3375 ALMA ST APT 181, PALO ALTO, CA 94306-3517
(406) 240-4876
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
95030128
CA
363LG0600X
Gerontology Nurse Practitioner
95030128
CA
Other
Enumeration date
07/22/2024
Last updated
09/17/2024
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