Healthcare Provider Details

I. General information

NPI: 1285011130
Provider Name (Legal Business Name): STEVEN KASPICK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 09/06/2022
Certification Date: 09/06/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6501 COYLE AVE
CARMICHAEL CA
95608-0306
US

IV. Provider business mailing address

2450 DEL PASO RD STE 250
SACRAMENTO CA
95834-9667
US

V. Phone/Fax

Practice location:
  • Phone: 916-537-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA149203
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: