Doctor Name: | NEDJELKO KRISTOVICH |
NPI Number: | 1063780740 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | N5020399 |
Business Practice Address: | 21555 Prospect Rd Saratoga, CA - 950706539 |
Business Phone Number: | 4085699442 |
Business Fax Number: | 4082573471 |
Mailing Address: | 21555 Prospect Rd, SARATOGA |
State: | CA |
Postal Code: | 950706539 |
Phone Number: | 4085699442 |
Fax Number: | 4082573471 |
NPI Enumeration Date: | 12/08/2011 |
NPI Last Update Date: | 12/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 172A00000X |
License Number: | N5020399 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Driver |
Taxonomy Specialization: | |
Taxonomy Definition: | A person employed to operate a motor vehicle as a carrier of persons or property. |