Provider Demographics
NPI:1114155215
Name:IGLOWITZ, MOOK-LAN SAUVIGNON (MD)
Entity Type:Individual
Prefix:
First Name:MOOK-LAN
Middle Name:SAUVIGNON
Last Name:IGLOWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MOOK-LAN
Other - Middle Name:SAUVIGNON
Other - Last Name:IGLOWITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4150 V STREET SUITE 3400
Mailing Address - Street 2:PALLIATIVE CARE DEPARTMENT
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95817
Mailing Address - Country:US
Mailing Address - Phone:916-734-8994
Mailing Address - Fax:
Practice Address - Street 1:4150 V STREET SUITE 3400
Practice Address - Street 2:PALLIATIVE CARE DEPARTMENT
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817
Practice Address - Country:US
Practice Address - Phone:916-734-8994
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-26
Last Update Date:2020-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA124327207QH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QH0002XAllopathic & Osteopathic PhysiciansFamily MedicineHospice and Palliative Medicine