Healthcare Provider Details

I. General information

NPI: 1316956378
Provider Name (Legal Business Name): SOFIE A DE NARDI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 04/06/2020
Certification Date: 04/06/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6555 COYLE AVE STE 280
CARMICHAEL CA
95608-0302
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-536-3540
  • Fax: 916-536-3541
Mailing address:
  • Phone: 916-861-1486
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA92880
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License NumberA92880
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: