Van Gundy, Elaine Therese
Van Gundy, Elaine Therese is an sole proprietor health care provider with primary practice located at 1451 Secret Ravine Pkwy Suite 150, Roseville CA 95661-4051. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Van Gundy, Elaine Therese can be contacted via phone (916) 580-2420.Contact Information
Primary practice address
1451 Secret Ravine Pkwy Suite 150
Roseville CA 95661-4051
Phone: (916) 580-2420
Fax: (916) 580-2402
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Specialist | 174400000X | C43153 | California |
Profile Details
| NPI number | 1174565485 |
|---|---|
| LBN Legal business name | Van Gundy, Elaine Therese |
| Credentials | M.D., F.A.A.P. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Jul 9th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1174565485 | NPPES |
| California | MEDICAID | 00C431530 |
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