Healthcare Provider Details

I. General information

NPI: 1942610795
Provider Name (Legal Business Name): NORTHERN CALIFORNIA ORTHOPAEDIC ASSOCIATES CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/02/2014
Last Update Date: 11/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SCRIPPS DR SUITE 101
SACRAMENTO CA
95825-6206
US

IV. Provider business mailing address

2443 FAIR OAKS BLVD # 394
SACRAMENTO CA
95825-7684
US

V. Phone/Fax

Practice location:
  • Phone: 916-512-6262
  • Fax: 916-512-6262
Mailing address:
  • Phone: 916-512-6262
  • Fax: 916-512-6262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberA68031
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberE4947
License Number StateCA

VIII. Authorized Official

Name: RON JAMES
Title or Position: PRESIDENT
Credential: MD
Phone: 916-512-6262