Healthcare Provider Details

I. General information

NPI: 1457785065
Provider Name (Legal Business Name): SAMANTHA N STRADLEIGH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SAMANTHA NEUREUTHER

II. Dates (important events)

Enumeration Date: 08/30/2013
Last Update Date: 02/11/2022
Certification Date: 10/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 EUREKA RD
ROSEVILLE CA
95661-3027
US

IV. Provider business mailing address

1600 EUREKA RD BLDG D
ROSEVILLE CA
95661-3027
US

V. Phone/Fax

Practice location:
  • Phone: 916-784-4000
  • Fax:
Mailing address:
  • Phone: 916-748-4144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License NumberA134169
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: