Healthcare Provider Details

I. General information

NPI: 1437780657
Provider Name (Legal Business Name): ALEXANDER ARNETT BYRD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/27/2020
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 UNIVERSITY AVE STE 120
SACRAMENTO CA
95825-6524
US

IV. Provider business mailing address

635 ANDERSON RD STE 19
DAVIS CA
95616-3505
US

V. Phone/Fax

Practice location:
  • Phone: 916-922-3668
  • Fax: 916-922-3636
Mailing address:
  • Phone: 510-758-1810
  • Fax: 510-758-1896

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE6261
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: