Healthcare Provider Details

I. General information

NPI: 1871753731
Provider Name (Legal Business Name): HSINJU RUBY GATSCHET M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/13/2008
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7551 TIMBERLAKE WAY STE 230
SACRAMENTO CA
95823-5422
US

IV. Provider business mailing address

220 STANDIFORD AVE STE F
MODESTO CA
95350-1159
US

V. Phone/Fax

Practice location:
  • Phone: 916-347-3630
  • Fax: 916-347-3632
Mailing address:
  • Phone: 209-579-5628
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number0000000
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: