Healthcare Provider Details

I. General information

NPI: 1841078151
Provider Name (Legal Business Name): SLAVIC-AMERICAN CHAMBER OF COMMERCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/18/2023
Last Update Date: 10/23/2023
Certification Date: 10/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5948 PECAN AVE
ORANGEVALE CA
95662-4624
US

IV. Provider business mailing address

3104 O ST # 399
SACRAMENTO CA
95816-6519
US

V. Phone/Fax

Practice location:
  • Phone: 916-759-7374
  • Fax:
Mailing address:
  • Phone: 916-207-2295
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251X00000X
TaxonomySupports Brokerage Agency
License Number
License Number State

VIII. Authorized Official

Name: SERGEY TEREBKOV
Title or Position: CEO/EXECUTIVE DIRECTOR
Credential:
Phone: 916-207-2295