Healthcare Provider Details

I. General information

NPI: 1972694289
Provider Name (Legal Business Name): JAMIE S SHERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/10/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9281 OFFICE PARK CIR #120
ELK GROVE CA
95758-8068
US

IV. Provider business mailing address

10470 OLD PLACERVILLE RD SUITE 100
SACRAMENTO CA
95827-2539
US

V. Phone/Fax

Practice location:
  • Phone: 916-691-5999
  • Fax: 916-691-6717
Mailing address:
  • Phone: 855-771-0335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA77623
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: