Healthcare Provider Details

I. General information

NPI: 1336963321
Provider Name (Legal Business Name): ELEQTRO SPOT LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2024
Last Update Date: 03/12/2025
Certification Date: 12/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3823 V ST
SACRAMENTO CA
95817-3145
US

IV. Provider business mailing address

3823 V ST
SACRAMENTO CA
95817-3145
US

V. Phone/Fax

Practice location:
  • Phone: 916-241-3676
  • Fax: 916-244-4804
Mailing address:
  • Phone: 916-241-3676
  • Fax: 916-244-4804

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code374700000X
TaxonomyTechnician
License Number
License Number State

VIII. Authorized Official

Name: ARELY Y AGUAYO RAMOS
Title or Position: OWNER
Credential: LICENSED ELECTROLOGI
Phone: 916-241-3676