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General NPI Number Information
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NPI Number | 1245644863
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Entity Type | Organization
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Legal Business Name | UAP SACRAMENTO, PC
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 12/15/2016
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Provider Practice Location Address
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Address Line | 2805 J ST 200
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City | SACRAMENTO
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State | CA
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Zip | 95816-4307
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Country | US
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Telephone | 916-231-8755
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Fax |
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Provider Business Mailing Address
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Address Line | 5 HOLLAND 101
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City | IRVINE
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State | CA
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Zip | 92618-2566
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Country | US
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Telephone | 949-588-2190
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Fax | 949-588-2199
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | DR. NIRVANA KUNDU
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Credential | M. D.
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Telephone | 530-665-3212
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology 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 | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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