Healthcare Provider Details

I. General information

NPI: 1336264290
Provider Name (Legal Business Name): DAVID PAUL FOOS DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2007
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1650 RESPONSE RD ADULT MEDICINE 2
SACRAMENTO CA
95815-4807
US

IV. Provider business mailing address

1650 RESPONSE RD ADULT MEDICINE 2
SACRAMENTO CA
95815-4807
US

V. Phone/Fax

Practice location:
  • Phone: 916-614-4652
  • Fax:
Mailing address:
  • Phone: 916-614-4652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number20A10349
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: