Healthcare Provider Details

I. General information

NPI: 1992754741
Provider Name (Legal Business Name): NORTHERN CALIFORNIA P.E.T. IMAGING CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/09/2006
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3195 FOLSOM BLVD
SACRAMENTO CA
95816-5233
US

IV. Provider business mailing address

3195 FOLSOM BLVD
SACRAMENTO CA
95816-5233
US

V. Phone/Fax

Practice location:
  • Phone: 916-737-3211
  • Fax: 916-737-6203
Mailing address:
  • Phone: 916-737-3211
  • Fax: 916-737-6203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR0200X
TaxonomyRadiology Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207U00000X
TaxonomyNuclear Medicine Physician
License Number
License Number StateCA

VIII. Authorized Official

Name: BRADLEY SCHMIDT
Title or Position: CEO
Credential:
Phone: 916-739-0788