Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | A140377 | CA |
N | 208600000X | Surgeon | A140377 | CA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | A140377 | CA |
N | 2086X0206X | Surgical Oncologist | A140377 | CA |
NPI | 1164680070 |
---|---|
Provider Name | Candice Anne Marcum Sauder |
First Address | Sacramento, CA 95817-2229 |
Second Address | Sacramento, CA 95817-2229 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2008 |
Last Update Date | 18/06/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
341619001 | (05) | TX |