| Doctor Name: | MR. CLELLAN MICHAEL SAULSBURY |
| NPI Number: | 1104081421 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RN FNP MS |
| License Number: | 173545 |
| Business Practice Address: | 193 Fairview Lane Suite L Sonora, CA - 95370 |
| Business Phone Number: | 2095363720 |
| Business Fax Number: | 2095363877 |
| Mailing Address: | 1000 Greenley Road, SONORA |
| State: | CA |
| Postal Code: | 95370 |
| Phone Number: | 2095365000 |
| Fax Number: | 2095363877 |
| NPI Enumeration Date: | 07/25/2008 |
| NPI Last Update Date: | 07/25/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LF0000X |
| License Number: | 173545 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Family |
| Taxonomy Definition: | |