Wandisan and Rosete Medical Group Professional Corporation
NPI #1316058795 in Tracy, California
Provider Information
- NPI Number
- 1316058795
- Entity Type
- Organization
- Organization Name
- Wandisan and Rosete Medical Group Professional Corporation
- Primary Specialty
- Internal Medicine
- Enumeration Date
- Aug 31, 2006
- Last Updated
- Jul 10, 2018
Practice Location
- Address
- 4600 S TRACY BLVD #107
- City
- Tracy
- State
- California
- ZIP Code
- 95377
- Phone
- (209) 836-4920
Authorized Official
- Name
- FLORENCE WANDISAN ROSETE, M.D
- Title
- CFO
- Phone
- (209) 836-4920
Specialties & Taxonomy Codes
| Specialty |
|---|
| Internal Medicine |
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