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General NPI Number Information
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NPI Number | 1215543178
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Entity Type | Organization
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Legal Business Name | ALLIED MEDICAL & DIAGNOSTIC GROUP, INC.
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Dates
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Enumeration Date | 09/16/2020
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Last Update Date | 09/16/2020
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Provider Practice Location Address
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Address Line | 7600 HOSPITAL DR STE J
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City | SACRAMENTO
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State | CA
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Zip | 95823-5406
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Country | US
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Telephone | 916-525-2021
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Fax |
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Provider Business Mailing Address
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Address Line | 7600 HOSPITAL DR STE J
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City | SACRAMENTO
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State | CA
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Zip | 95823-5406
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Country | US
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Telephone | 916-525-2021
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Fax |
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Authorized Official
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Title or Position | PROVIDER
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Name | REBECCA JORDAN
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Credential |
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Telephone | 916-525-2021
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RA0401X
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Taxonomy Name | Addiction Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2081P2900X
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Taxonomy Name | Pain Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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