Provider Demographics
NPI:1962409573
Name:ARCHER, JULIE ANN (MD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:ANN
Last Name:ARCHER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1645 ESPLANADE
Mailing Address - Street 2:STE # 1
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926-3312
Mailing Address - Country:US
Mailing Address - Phone:530-896-0386
Mailing Address - Fax:530-896-0389
Practice Address - Street 1:1645 ESPLANADE
Practice Address - Street 2:STE # 1
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926-3312
Practice Address - Country:US
Practice Address - Phone:530-896-0386
Practice Address - Fax:530-896-0389
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG68085207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G680850Medicare ID - Type Unspecified
CAE62602Medicare UPIN