| Jude Waterbury Inc | |
|
8100 Timberlake Way #d Sacramento CA 95823-5409 | |
| (916) 689-8606 | |
| Not Available |
| Full Name | Jude Waterbury Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8100 Timberlake Way, Sacramento, California |
| Authorized Official Name and Position | Jude Waterbury (PHYSICIAN OWNER) |
| Authorized Official Contact | 9166898606 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jude Waterbury Inc 8100 Timberlake Way #d Sacramento CA 95823-5409 Ph: (916) 689-8606 | Jude Waterbury Inc 8100 Timberlake Way #d Sacramento CA 95823-5409 Ph: (916) 689-8606 |
| NPI Number | 1255540241 |
|---|---|
| Provider Enumeration Date | 05/22/2007 |
| Last Update Date | 04/04/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255540241 | NPI | - | NPPES |
| 00A909910 | Medicaid | CA | |
| 00A909910 | Other | CA | BLUE SHIELD |
| DE3856 | Other | CA | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | A90991 (California) | Primary |
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