Healthcare Provider Details

I. General information

NPI: 1093713240
Provider Name (Legal Business Name): DENNIE L SCHULTHEIS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 12/16/2019
Certification Date: 12/16/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3946 NORWOOD AVE
SACRAMENTO CA
95838-3300
US

IV. Provider business mailing address

712 TURNSTONE DR
SACRAMENTO CA
95834-1508
US

V. Phone/Fax

Practice location:
  • Phone: 916-737-5555
  • Fax: 877-860-2907
Mailing address:
  • Phone: 707-845-1846
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA60337
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: