Regents/ucdpbg/imgastro | |
4860 Y St Sacramento CA 95817-2307 | |
(916) 734-8046 | |
(916) 734-2732 |
Full Name | Regents/ucdpbg/imgastro |
---|---|
Speciality | Internal Medicine - Gastroenterology |
Location | 4860 Y St, Sacramento, California |
Authorized Official Name and Position | Cheryl Sadro (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 9167035009 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Regents/ucdpbg/imgastro 10850 White Rock Rd Rancho Cordova CA 95670-6044 Ph: (916) 734-9200 | Regents/ucdpbg/imgastro 4860 Y St Sacramento CA 95817-2307 Ph: (916) 734-8046 |
NPI Number | 1043203102 |
---|---|
Provider Enumeration Date | 08/24/2005 |
Last Update Date | 08/08/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1043203102 | NPI | - | NPPES |
CN4400 | Other | CA | RAILROAD MEDICARE PIN |
CI4127 | Other | CA | RAILROAD MEDICARE PIN |
GRW02104A | Medicaid | CA | |
GNP000070 | Medicaid | CA | |
CN4844 | Other | CA | RAILROAD MEDICARE PIN |
GR0021047 | Medicaid | CA | |
DA4168 | Other | CA | RAILROAD MEDICARE PIN |
DE7275 | Other | CA | RAILROAD MEDICARE PIN |
CR0028 | Other | CA | RAILROAD MEDICARE PIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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