Basic Information
| Provider Information | |||||||||
| NPI: | 1538229687 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LEMONS | ||||||||
| FirstName: | VAN BUREN | ||||||||
| MiddleName: | ROSS | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3415 AMERICAN RIVER DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958645794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166480144 | ||||||||
| FaxNumber: | 9166480155 | ||||||||
| Practice Location | |||||||||
| Address1: | 3415 AMERICAN RIVER DR | ||||||||
| Address2: | SUITE A | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958645794 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166480144 | ||||||||
| FaxNumber: | 9166480155 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2006 | ||||||||
| LastUpdateDate: | 05/25/2012 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | G60902 | CA | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.