Healthcare Provider Details

I. General information

NPI: 1689625337
Provider Name (Legal Business Name): RAYE LYNN BELLINGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 11/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY AVE.
SACRAMENTO CA
95825-6524
US

IV. Provider business mailing address

500 UNIVERSITY AVE.
SACRAMENTO CA
95825-6524
US

V. Phone/Fax

Practice location:
  • Phone: 916-830-2000
  • Fax: 916-830-2001
Mailing address:
  • Phone: 916-830-2000
  • Fax: 916-830-2001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207UN0901X
TaxonomyNuclear Cardiology Physician
License NumberA44408
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA44408
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: