Healthcare Provider Details

I. General information

NPI: 1740817923
Provider Name (Legal Business Name): DR. OLIVER RALPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/26/2020
Last Update Date: 06/13/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2335 STOCKTON BLVD FL 5
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

2335 STOCKTON BLVD FL 5
SACRAMENTO CA
95817-2201
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-5638
  • Fax:
Mailing address:
  • Phone: 916-734-5638
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberA206074
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberA206074
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: