Healthcare Provider Details

I. General information

NPI: 1356064877
Provider Name (Legal Business Name): DAVID NEGRETE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2022
Last Update Date: 07/27/2024
Certification Date: 07/27/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 BROADWAY STE 100
SACRAMENTO CA
95820-1541
US

IV. Provider business mailing address

4800 BROADWAY STE 100
SACRAMENTO CA
95820-1541
US

V. Phone/Fax

Practice location:
  • Phone: 916-874-9320
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZF0201X
TaxonomyForensic Pathology Physician
License NumberA182116
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License NumberA182116
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: