Healthcare Provider Details

I. General information

NPI: 1942478615
Provider Name (Legal Business Name): MICHAEL G. ADELBERG, A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/15/2008
Last Update Date: 02/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9856 BUSINESS PARK DR SUITE I
SACRAMENTO CA
95827-1741
US

IV. Provider business mailing address

9856 BUSINESS PARK DR SUITE I
SACRAMENTO CA
95827-1741
US

V. Phone/Fax

Practice location:
  • Phone: 916-362-5112
  • Fax: 916-362-6115
Mailing address:
  • Phone: 916-362-5112
  • Fax: 916-362-6115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License NumberG367970
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. DEBBY GILZEAN ORTEGA
Title or Position: OFFICE MANAGER
Credential:
Phone: 916-362-5112