Healthcare Provider Details

I. General information

NPI: 1669056529
Provider Name (Legal Business Name): MAXWELL JONATHAN PRESSER MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: MAX JONATHAN PRESSER

II. Dates (important events)

Enumeration Date: 05/07/2021
Last Update Date: 05/07/2021
Certification Date: 04/09/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2335 STOCKTON BOULEVARD
SACRAMENTO CA
95817
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-2724
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: