Provider Information for 1528510021
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CAMERON CLELAND
Sex: Male
NPI: 1528510021
Last Updated: 2016-10-31
Certification Date:
Certification Date:
Details
| Name | Value | ||||||||
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| NPI | 1528510021 | ||||||||
| Enumeration Date | 2016-10-31 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2210 BIG NUGGET TRL COOL, CA 95614-2200 United States Phone: 530-718-4970 | Fax: | ||||||||
| Primary Practice Address | 212 JUDAH ST ROSEVILLE, CA 95678-2608 United States Phone: 916-572-8124 | Fax: | ||||||||
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