Healthcare Provider Details

I. General information

NPI: 1003971003
Provider Name (Legal Business Name): SHARMILA P. AMOLIK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 05/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2575 E BIDWELL ST STE 100
FOLSOM CA
95630-6445
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 916-817-3700
  • Fax: 916-817-3701
Mailing address:
  • Phone: 866-681-0736
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA76753
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: