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General NPI Number Information
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NPI Number | 1578845657
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Entity Type | Organization
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Legal Business Name | SACRAMENTO ULTRASOUND, INC.
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 10/29/2012
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Provider Practice Location Address
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Address Line | 2233 WATT AVE SUITE 150
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City | SACRAMENTO
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State | CA
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Zip | 95825-0509
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Country | US
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Telephone | 916-752-7750
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Fax | 916-487-4032
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Provider Business Mailing Address
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Address Line | 2233 WATT AVE SUITE 150
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City | SACRAMENTO
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State | CA
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Zip | 95825-0509
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Country | US
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Telephone | 916-752-7750
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Fax | 916-487-4032
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Authorized Official
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Title or Position | DIAGNOSTIC MEDICAL SONOGRAPHER
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Name | MS. SIMA DERMISHYAN
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Credential |
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Telephone | 916-752-7750
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0200X
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Taxonomy Name | Radiology Clinic/Center
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License Number | RHT 102230
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License Number State | CA
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