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General NPI Number Information
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NPI Number | 1568015808
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Entity Type | Organization
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Legal Business Name | SIERRA MEDICAL PARTNERSHIP
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Dates
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Enumeration Date | 07/16/2019
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 1625 CREEKSIDE DR STE 200
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City | FOLSOM
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State | CA
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Zip | 95630-3819
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Country | US
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Telephone | 916-365-2987
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Fax |
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Provider Business Mailing Address
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Address Line | 1625 CREEKSIDE DR STE 202
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City | FOLSOM
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State | CA
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Zip | 95630-3819
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Country | US
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Telephone | 916-663-2100
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Fax | 916-663-2103
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Authorized Official
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Title or Position | GENERAL PARTNER
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Name | DR. KYLE MCCLINTOCK
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Credential | DO
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Telephone | 916-663-2100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine 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 | 207R00000X
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Taxonomy Name | 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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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