GREATER SACRAMENTO PEDIATRICS ASSOC INC NPI 1528196565

NPI Information

NPI: 1528196565
Provider Name: GREATER SACRAMENTO PEDIATRICS ASSOC INC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 05D0707525

Address:
1301 SECRET RAVINE PKWY
SUITE 140
ROSEVILLE, CA
ZIP 95661
Phone: (916) 788-3030
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GREATER SACRAMENTO PEDIATRICS ASSOC INC is a health service clinic center in Roseville, CA. GREATER SACRAMENTO PEDIATRICS ASSOC INC NPI is 1528196565. The provider is registered as an organization entity type.

The provider's business location address is:

1301 SECRET RAVINE PKWY
SUITE 140
ROSEVILLE, CA
ZIP 95661-102
Phone: (916) 788-3030
Fax: (916) 788-0171

The provider's authorized official is Mehdi Arab .
The authorized official title is President and has the following contact phone number (916) 965-4612.

The CLIA number assigned to this NPI record is 05D0707525 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/1/2007 and was last updated on 2/23/2013.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	=========	OTHER	CALIFORNIA	TAX ID NUMBER

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: 11/14/2023

NPI Synchronization or Removal

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