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General NPI Number Information
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NPI Number | 1467053272
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Entity Type | Organization
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Legal Business Name | WEST SACRAMENTO PRIMARY CARE INC.
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Dates
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Enumeration Date | 11/06/2020
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 2455 JEFFERSON BLVD STE 100
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-5329
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Country | US
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Telephone | 916-617-2377
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Fax |
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Provider Business Mailing Address
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Address Line | 2455 JEFFERSON BLVD STE 100
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City | WEST SACRAMENTO
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State | CA
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Zip | 95691-5329
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ZIAD ALI
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Credential | MD
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Telephone | 209-334-5719
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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