Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 20A6393 | CA |
N | 207Q00000X | Family Doctor | 20A6393 | CA |
NPI | 1649317165 |
---|---|
Provider Name | Dr. Veronica Vuksich |
First Address | Santa Rosa, CA 95401-0805 |
Second Address | Santa Rosa, CA 95404-6617 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G11326 | (02) | CA |