Healthcare Provider Details

I. General information

NPI: 1508339375
Provider Name (Legal Business Name): NANCY E ROLNIK MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/04/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 LA CASA VIA # 106
WALNUT CREEK CA
94598-3013
US

IV. Provider business mailing address

108 LA CASA VIA # 106
WALNUT CREEK CA
94598-3013
US

V. Phone/Fax

Practice location:
  • Phone: 925-464-7278
  • Fax: 925-464-1318
Mailing address:
  • Phone: 925-464-7278
  • Fax: 925-464-1318

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NANCY ROLNIK
Title or Position: OWNER
Credential: MD
Phone: 925-464-7278