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General NPI Number Information
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NPI Number | 1285544163
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Entity Type | Organization
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Legal Business Name | CAPITAL CITY MEDICAL MONITORING
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Dates
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Enumeration Date | 09/11/2026
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Last Update Date | 09/11/2026
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Provider Practice Location Address
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Address Line | 5346 MADISON AVE STE DANDE
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City | SACRAMENTO
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State | CA
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Zip | 95841-3166
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Country | US
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Telephone | 916-964-6480
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Fax | 916-964-6481
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Provider Business Mailing Address
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Address Line | 5346 MADISON AVE STE DANDE
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City | SACRAMENTO
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State | CA
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Zip | 95841-3166
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Country | US
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Telephone | 916-964-6480
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Fax | 916-964-6481
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Authorized Official
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Title or Position | CEO
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Name | ALEXANDER USOROV
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Credential | MD
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Telephone | 720-255-7016
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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