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Geraldine M Dutra, PA
Surgical Physician Assistant in Woodland, California
NPI 1396917043

Geraldine M Dutra is a Surgical Physician Assistant based in Woodland, CA and is specialized in Surgical. Geraldine M Dutra practices in Woodland, CA and has the professional credentials of PA. The NPI Number for Geraldine M Dutra is 1396917043 and holds a License No. PA14146 (California).

The current practice location address for Geraldine M Dutra is 632 W Gibson Rd, Woodland, CA and can be reached out via phone at 530-668-2600.

Location: 632 W Gibson Rd, Woodland, CA, 95695-5169
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1396917043
Provider Name
Geraldine M Dutra
Credential
PA
Provider Entity Type
Individual
Gender
Female
Address
632 W Gibson Rd, Woodland, CA, 95695-5169
Phone Number
530-668-2600
Fax Number
Provider Enumeration Date
04/01/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
GR0079250 05 CA
ZZZ13239Z 01 CA GROUP PTAN
PA14146 01 CA PA LICENSE
institution
Provider Business Practice Location Address Details
Address
632 W Gibson Rd
City
Woodland
State
California
Zip
95695-5169
Phone Number
530-668-2600
Fax Number
person
Provider Business Mailing Address Details
Address
632 W Gibson Rd
City
Woodland
State
California
Zip
95695-5169
Phone Number
530-668-2600
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
363AS0400X
License No.
PA14146 (California)
Definition
Definition to come...
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