SKYLER INGEMANSSON, PA-C - NPI NUMBER 1942548482

Summary

Provider Name: SKYLER INGEMANSSON, PA-C

NPI Number: 1942548482

Clasification: Physician Assistant (363AM0700X)

Specialization: Medical

Address:
4112 E COMMERCE WAY
SACRAMENTO, CA
ZIP 95834

Phone Number: (916) 447-6337



Detailed Information

Skyler Ingemansson, PA-C is a medical physician assistant in Sacramento, CA. The assigned NPI number for this provider is 1942548482 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

4112 E COMMERCE WAY
SACRAMENTO, CA
ZIP 95834-680
Phone: (916) 447-6337

The enumeration date for this NPI number is 1/17/2013 and was last updated on 1/17/2013.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 363AM0700X Physician Assistant Medical 22784 CA Yes

NPI Record

No. Field Name Field Value
1 NPI 1942548482
2 Entity Type Code 1
3 Provider Last Name Legal Name INGEMANSSON
4 Provider First Name SKYLER
5 Provider Credential Text PA-C
6 Provider First Line Business Practice Location Address 4112 E COMMERCE WAY
7 Provider Business Practice Location Address City Name SACRAMENTO
8 Provider Business Practice Location Address State Name CA
9 Provider Business Practice Location Address Postal Code 958349680
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 9164476337
12 Provider Enumeration Date 1/17/2013
13 Last Update Date 1/17/2013
14 Provider Gender Code M
15 Healthcare Provider Taxonomy Code 1 363AM0700X
16 Provider License Number 1 22784
17 Provider License Number State Code 1 CA
18 Healthcare Provider Primary Taxonomy Switch 1 Y
19 Is Sole Proprietor N

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This page was last updated on: 8/12/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.