Provider Demographics
NPI:1194744045
Name:LONG, FRANKLIN ROY (MD MPHTM)
Entity type:Individual
Prefix:DR
First Name:FRANKLIN
Middle Name:ROY
Last Name:LONG
Suffix:
Gender:M
Credentials:MD MPHTM
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Mailing Address - Street 1:600 WOODSIDE SIERRA UNIT 2
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-7525
Mailing Address - Country:US
Mailing Address - Phone:916-704-1726
Mailing Address - Fax:
Practice Address - Street 1:320 LENNON LN
Practice Address - Street 2:
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2419
Practice Address - Country:US
Practice Address - Phone:925-906-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA053745207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAG42257Medicare UPIN