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Immanuel Selassie I
NPI 1053601039 · on the registry since 2011 · sole proprietor
Practice
- Address
- 2430 Fair Oaks Blvd (Apt 120)
Sacramento, CA 95825 - Phone
- (206) 384-6915
Registry record
- Primary taxonomy
- Dentist
122300000X
- Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-02-28
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California