Henjum, Stanley C

Henjum, Stanley C is an individual health care provider with primary practice located at 1004 Fowler Way #4, Placerville CA 95667-5746. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Henjum, Stanley C can be contacted via phone (530) 626-9488.

Contact Information

Primary practice address
1004 Fowler Way #4 Placerville CA 95667-5746
Phone: (530) 626-9488
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X G62392 California

Profile Details

NPI number 1144200486
LBN Legal business name Henjum, Stanley C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 20th, 2006
Last updated Jan 12th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144200486 NPPES
California MEDICAID 00G623920
California Other 90095380

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