person
Mr. Edman Fuentes, PAC
Surgical Physician Assistant in Sonora, California
NPI 1013988955

Edman Fuentes is a Surgical Physician Assistant based in Pleasanton, CA and is specialized in Surgical. Edman Fuentes practices in Sonora, CA and has the professional credentials of PAC. The NPI Number for Edman Fuentes is 1013988955 and holds a License No. PA51630 (California).

The current practice location address for Edman Fuentes is 900 Greenley Rd, Sonora, CA and can be reached out via phone at 925-469-6274 and via fax at 925-924-1769.

Location: 900 Greenley Rd, Sonora, CA, 94588-4054
person
Provider Profile Details
NPI Number
1013988955
Provider Name
Edman Fuentes
Credential
PAC
Provider Entity Type
Individual
Gender
Male
Address
900 Greenley Rd, Sonora, CA, 94588-4054
Phone Number
925-469-6274
Fax Number
925-924-1769
Provider Enumeration Date
01/30/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
291613400 05 FL
PA51630 01 CA MEDICAL LICENSE
PA9102297 01 FL MEDICAL LICENSE
institution
Provider Business Practice Location Address Details
Address
900 Greenley Rd
City
State
Zip
95370-5287
Phone Number
925-469-6274
Fax Number
925-924-1769
person
Provider Business Mailing Address Details
Address
900 Greenley Rd
City
State
Zip
95370-5287
Phone Number
925-469-6274
Fax Number
925-924-1769
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
PA51630 (California)
Definition
Definition to come...
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