Doctor Name: | DEVAMANI GOWDA |
NPI Number: | 1962463455 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | 00A453940 |
Business Practice Address: | Three Medical Plaza Suite 140 Roseville, CA - 95661 |
Business Phone Number: | 9167974715 |
Business Fax Number: | 9167974716 |
Mailing Address: | 10470 Old Placerville Rd, Suite 100 SACRAMENTO |
State: | CA |
Postal Code: | 958272539 |
Phone Number: | 8004700071 |
Fax Number: | |
NPI Enumeration Date: | 04/01/2006 |
NPI Last Update Date: | 04/26/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 00A453940 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |