Healthcare Provider Details

I. General information

NPI: 1922107564
Provider Name (Legal Business Name): BOBBI S UNDERHILL DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 04/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 J ST SUITE 201
SACRAMENTO CA
95816-5562
US

IV. Provider business mailing address

3701 J ST SUITE 201
SACRAMENTO CA
95816-5562
US

V. Phone/Fax

Practice location:
  • Phone: 855-354-2242
  • Fax: 916-457-6227
Mailing address:
  • Phone: 855-354-2242
  • Fax: 916-457-6227

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number20A7564
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: