Healthcare Provider Details

I. General information

NPI: 1780906875
Provider Name (Legal Business Name): JOAN O'DWYER SLACHMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JOAN THERESA O'DWYER MD

II. Dates (important events)

Enumeration Date: 02/17/2010
Last Update Date: 02/11/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7154 SUTTER AVE
CARMICHAEL CA
95608-2856
US

IV. Provider business mailing address

7154 SUTTER AVE
CARMICHAEL CA
95608-2856
US

V. Phone/Fax

Practice location:
  • Phone: 916-944-3400
  • Fax: 916-944-3440
Mailing address:
  • Phone: 916-944-3400
  • Fax: 916-944-3440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberG49096
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: