Healthcare Provider Details

I. General information

NPI: 1710199583
Provider Name (Legal Business Name): FRANCIS J SOUSA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2315 STOCKTON BLVD
SACRAMENTO CA
95817-2201
US

IV. Provider business mailing address

1608 HOLLY LN
DAVIS CA
95616-1010
US

V. Phone/Fax

Practice location:
  • Phone: 916-734-7005
  • Fax:
Mailing address:
  • Phone: 530-753-8031
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberG31242
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: