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General NPI Number Information
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NPI Number | 1891947859
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Entity Type | Organization
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Legal Business Name | ROLF N. GULBRANDSON, M.D., INC.
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Dates
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Enumeration Date | 10/21/2008
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Last Update Date | 10/21/2008
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Provider Practice Location Address
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Address Line | 5 MEDICAL PLAZA DR SUITE 120
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City | ROSEVILLE
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State | CA
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Zip | 95661-2865
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Country | US
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Telephone | 916-782-2500
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Fax | 916-782-9424
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Provider Business Mailing Address
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Address Line | 5 MEDICAL PLAZA DR SUITE 120
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City | ROSEVILLE
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State | CA
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Zip | 95661-2865
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Country | US
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Telephone | 916-782-2500
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Fax | 916-782-9424
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Authorized Official
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Title or Position | OWNER
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Name | DR. ROLF N. GULBRANDSON
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Credential | M.D.
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Telephone | 916-781-2500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A25350
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License Number State | CA
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