Healthcare Provider Details
I. General information
NPI: 1144253352
Provider Name (Legal Business Name): JOYCE ANN LOEFFLER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/09/2006
Last Update Date: 06/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1321 COTTONWOOD ST 3RD FLOOR
WOODLAND CA
95695-5131
US
IV. Provider business mailing address
3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US
V. Phone/Fax
- Phone: 530-668-2600
- Fax: 530-661-3034
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | MD00040374 |
| License Number State | WA |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208800000X |
| Taxonomy | Urology Physician |
| License Number | G84054 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: