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9245 Laguna Springs Dr Suite 200 Elk Grove CA 95758-7987 | |
| (206) 624-6050 | |
| (206) 838-3085 |
| Full Name | |
|---|---|
| Speciality | Family Medicine |
| Location | 9245 Laguna Springs Dr, Elk Grove, California |
| Authorized Official Name and Position | Benjamin Michael Green (OWNER) |
| Authorized Official Contact | 2069142389 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
1525 4th Ave Suite 300 Seattle WA 98101-1607 Ph: (206) 838-6856 | 9245 Laguna Springs Dr Suite 200 Elk Grove CA 95758-7987 Ph: (206) 624-6050 |
| NPI Number | 1114299740 |
|---|---|
| Provider Enumeration Date | 01/27/2012 |
| Last Update Date | 01/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114299740 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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