Healthcare Provider Details

I. General information

NPI: 1114155215
Provider Name (Legal Business Name): MOOK-LAN SAUVIGNON IGLOWITZ M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MOOK-LAN SAUVIGNON IGLOWITZ MD

II. Dates (important events)

Enumeration Date: 06/26/2009
Last Update Date: 04/10/2020
Certification Date: 04/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V STREET SUITE 3400 PALLIATIVE CARE DEPARTMENT
SACRAMENTO CA
95817
US

IV. Provider business mailing address

4150 V STREET SUITE 3400 PALLIATIVE CARE DEPARTMENT
SACRAMENTO CA
95817
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-8994
  • Fax:
Mailing address:
  • Phone: 916-734-8994
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QH0002X
TaxonomyHospice and Palliative Medicine (Family Medicine) Physician
License NumberA124327
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: