Healthcare Provider Details

I. General information

NPI: 1679773964
Provider Name (Legal Business Name): SEBASTIAN CONTI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 01/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6450 COYLE AVE SUITE 1
CARMICHAEL CA
95608-0305
US

IV. Provider business mailing address

6450 COYLE AVE SUITE 1
CARMICHAEL CA
95608-0305
US

V. Phone/Fax

Practice location:
  • Phone: 916-965-5050
  • Fax: 916-965-4040
Mailing address:
  • Phone: 916-965-5050
  • Fax: 916-965-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberG34056
License Number StateCA

VIII. Authorized Official

Name: DR. SEBASTIAN CONTI
Title or Position: OWNER
Credential: M.D.
Phone: 916-965-5050