Healthcare Provider Details

I. General information

NPI: 1588660740
Provider Name (Legal Business Name): NED J WHITCOMB MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 06/22/2005
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3609 MISSION AVE STE A
CARMICHAEL CA
95608-2955
US

IV. Provider business mailing address

3609 MISSION AVE STE A
CARMICHAEL CA
95608-2955
US

V. Phone/Fax

Practice location:
  • Phone: 916-972-1888
  • Fax: 916-972-7339
Mailing address:
  • Phone: 916-972-1888
  • Fax: 916-972-7339

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207KA0200X
TaxonomyAllergy Physician
License NumberC28868
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: