1578650883

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DERDZINSKA B ANNA MD

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Provider Last Name Provider Middle Name Provider First Name Provider Credential
DERDZINSKA B ANNA MD
Gender:
Female
Enumeration date:
2006-10-06
Last update date:
2015-05-08
Current as of:
Is sole proprietor?:
No
Is organization subpart?:
No
In PECOS?:
Yes
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Identifiers

identifier description issuer state
00A424890 Medicaid none CA

Taxonomies

Taxonomy State License Number Primary?
208000000X Pediatrics CA A42489 Y

Phone Numbers

Type Number
Mailing Address Telephone Number 8004700071
Practice Location Address Telephone Number 7074274900
Practice Location Address Fax Number 7074342090

Addresses

Type Address City State Postal Country
Mailing Address 10470 OLD PLACERVILLE RD SACRAMENTO CA 95827 CA
Practice Location Address 2720 LOW CT ST 100 FAIRFIELD CA 0 CA

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Organization
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Individual
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Organization
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Organization
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Individual
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Individual
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Organization
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Organization
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Organization
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Organization
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Individual
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Organization
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Organization
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Organization
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Organization
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Organization
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Organization
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Individual
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Individual
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Organization
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Organization
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Organization
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
2020 SUTTER PL CA DAVIS
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
2020 SUTTER PL CA DAVIS
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
2020 SUTTER PLACE CA DAVIS
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Organization
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Organization
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Organization
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Organization
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Organization
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Individual
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Individual
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Individual
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Individual
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Individual
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Organization
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Organization
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Individual
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Organization
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Organization
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Organization
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Individual
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