Healthcare Provider Details

I. General information

NPI: 1962987644
Provider Name (Legal Business Name): PHYLLIS E NAPOLES MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 09/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2800 L ST STE 200
SACRAMENTO CA
95816-5616
US

IV. Provider business mailing address

2800 L ST STE 200
SACRAMENTO CA
95816-5616
US

V. Phone/Fax

Practice location:
  • Phone: 916-456-4428
  • Fax: 916-456-4465
Mailing address:
  • Phone: 916-456-4428
  • Fax: 916-456-4465

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PHYLLIS E NAPOLES
Title or Position: OWNER
Credential: M.D.
Phone: 916-456-4428