Healthcare Provider Details

I. General information

NPI: 1003843558
Provider Name (Legal Business Name): ROBERT JAMES BEMRICK II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 02/11/2020
Certification Date: 02/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6305 COYLE AVE
CARMICHAEL CA
95608-0438
US

IV. Provider business mailing address

3400 DATA DR
RANCHO CORDOVA CA
95670-7956
US

V. Phone/Fax

Practice location:
  • Phone: 916-961-6920
  • Fax: 916-966-5063
Mailing address:
  • Phone: 916-535-2000
  • Fax: 916-535-2020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberG84454
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberG84454
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: