Healthcare Provider Details

I. General information

NPI: 1447181573
Provider Name (Legal Business Name): SIERRA COAST INTERVENTIONAL PAIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 I ST STE 300
SACRAMENTO CA
95816-4442
US

IV. Provider business mailing address

PO BOX 254577
SACRAMENTO CA
95865-4577
US

V. Phone/Fax

Practice location:
  • Phone: 916-264-9757
  • Fax: 916-352-6406
Mailing address:
  • Phone: 916-264-9757
  • Fax: 916-352-6406

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code208VP0014X
TaxonomyInterventional Pain Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. MARY PEARSALL
Title or Position: CHIEF OF OPERATIONS
Credential:
Phone: 916-264-9757