Healthcare Provider Details

I. General information

NPI: 1386345122
Provider Name (Legal Business Name): GEORGE NJOROGE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 03/16/2023
Certification Date: 03/16/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 EXPOSITION BLVD APT 444
SACRAMENTO CA
95815-5138
US

IV. Provider business mailing address

1501 EXPOSITION BLVD APT 444
SACRAMENTO CA
95815-5138
US

V. Phone/Fax

Practice location:
  • Phone: 530-785-9642
  • Fax:
Mailing address:
  • Phone: 530-785-9642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code342000000X
TaxonomyTransportation Network Company
License NumberF3487471
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: