Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RG0300X | Geriatric Medicine | A108488 | CA |
NPI | 1154443117 |
---|---|
Provider Name | Dr. Wynnelena Canlas Canio |
First Address | Santa Rosa, CA 95403-2149 |
Second Address | Santa Rosa, CA 95403-2149 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/04/2007 |
Last Update Date | 15/12/2021 |