Healthcare Provider Details

I. General information

NPI: 1003892993
Provider Name (Legal Business Name): ALISON SEMRAD D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/21/2005
Last Update Date: 05/28/2020
Certification Date: 05/28/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4150 V ST #3116
SACRAMENTO CA
95817-1460
US

IV. Provider business mailing address

4150 V ST #G0400
SACRAMENTO CA
95817-1460
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7080
  • Fax:
Mailing address:
  • Phone: 916-734-3730
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number20A9354
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: