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EAST SACRAMENTO PEDIATRIC MEDICAL GROUP INC NPI 1093353195


NPI Information

NPI: 1093353195
Provider Name: EAST SACRAMENTO PEDIATRIC MEDICAL GROUP INC
Classification: Pediatrics - 208000000X
Entity Type: Organization

CLIA Number: 05D0615712

Address:
5030 J ST STE 301
SACRAMENTO, CA
ZIP 95819
Phone: (916) 451-8430
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EAST SACRAMENTO PEDIATRIC MEDICAL GROUP INC is a pediatrics in Sacramento, CA. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. EAST SACRAMENTO PEDIATRIC MEDICAL GROUP INC NPI is 1093353195. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5030 J ST STE 301
SACRAMENTO, CA
ZIP 95819-800
Phone: (916) 451-8430

The provider's authorized official is Ravinder Singh Khaira .
The authorized official title is Owner/physician and has the following contact phone number (916) 451-8430.

The CLIA number assigned to this NPI record is 05D0615712 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/19/2019 and was last updated on 12/19/2019.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208000000XPediatricsYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11588600431MEDICAIDCALIFORNIA
21811383490MEDICAIDCALIFORNIA
31902842354MEDICAIDCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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