Healthcare Provider Details
I. General information
NPI: 1003706599
Provider Name (Legal Business Name): AK DOMA MEDICAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2710 GATEWAY OAKS DR STE 100
SACRAMENTO CA
95833-3505
US
IV. Provider business mailing address
2915 CALIFORNIA AVE
CARMICHAEL CA
95608-4501
US
V. Phone/Fax
- Phone: 916-925-7010
- Fax:
- Phone: 916-899-1584
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 251G00000X |
| Taxonomy | Community Based Hospice Care Agency |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
ANAMIKA
DOMA
Title or Position: PHYSICIAN
Credential: DO
Phone: 916-899-1584