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NPI Code Detail

MEDICARE: DIANE LOUISE SIPKIN M.D.

MEDICARE: DIANE LOUISE SIPKIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianG42724CA

General Provider Information

NPI Number : 1194713107
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE LOUISE SIPKIN M.D.
Provider Business Mailing Address
First Line : 1700 11TH AVE
Second Line :
City : SACRAMENTO
State : CA
Zip : 95818-4141
Country : US
Telephone Number : 916-444-3429
Fax Number :
Provider Business Practice Location Address
First Line : 6000 J ST
Second Line : SACRAMENTO STATE STUDENT HEALTH CENTER
City : SACRAMENTO
State : CA
Zip : 95819-2605
Country : US
Telephone Number : 916-278-6461
Fax Number : 916-278-7359
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2005
Last Update Date : 07/08/2007

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Directions to “ DIANE LOUISE SIPKIN M.D.” Practice Location

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