Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | A79156 | CA |
NPI | 1215961511 |
---|---|
Provider Name | Dr. Theresa C Murdock-Vlautin |
First Address | Sacramento, CA 95817-2208 |
Second Address | Sacramento, CA 95817-2208 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2006 |
Last Update Date | 29/05/2020 |