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General NPI Number Information
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NPI Number | 1023831922
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Entity Type | Organization
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Legal Business Name | STATIONMD CALIFORNIA PC
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Dates
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Enumeration Date | 11/07/2024
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 2740 FULTON AVE
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City | SACRAMENTO
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State | CA
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Zip | 95821-5108
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Country | US
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Telephone | 908-663-2929
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Fax |
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Provider Business Mailing Address
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Address Line | 515 VALLEY ST STE 203
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City | MAPLEWOOD
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State | NJ
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Zip | 07040-4300
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Country | US
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Telephone | 908-663-2929
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Fax |
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Authorized Official
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Title or Position | CHIEF MEDICAL OFFICER
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Name | DEVEN UNADKAT
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Credential | DO
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Telephone | 908-663-2929
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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