Willie Dean
Willie Dean is an Exclusive Provider Organization in Modesto, California. Licensed in California. Registered with an NPI since 2007.
- Licensed in
- CA
- In the registry since
- 2007
Practice location Address checks out
1012 Raube CtModesto, CA 95351-2417
Phone: (209) 544-9377
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Exclusive Provider Organization (primary) | Taxonomy 302F00000X · Licence VN128313 (CA) |
|---|
Record details
| NPI number | 1831309848 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Willie Dean — Lvn · (209) 688-7720 |
| NPI enumerated | May 22, 2007 |
| Last updated in NPPES | August 22, 2020 |
| Mailing address | 5288 Barbados Cir, Stockton, CA 95210-6605 |
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