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General NPI Number Information
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NPI Number | 1679773964
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Entity Type | Organization
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Legal Business Name | SEBASTIAN CONTI
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Dates
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Enumeration Date | 07/24/2007
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Last Update Date | 01/08/2014
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Provider Practice Location Address
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Address Line | 6450 COYLE AVE SUITE 1
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City | CARMICHAEL
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State | CA
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Zip | 95608-0305
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Country | US
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Telephone | 916-965-5050
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Fax | 916-965-4040
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Provider Business Mailing Address
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Address Line | 6450 COYLE AVE SUITE 1
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City | CARMICHAEL
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State | CA
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Zip | 95608-0305
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Country | US
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Telephone | 916-965-5050
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Fax | 916-965-4040
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Authorized Official
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Title or Position | OWNER
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Name | DR. SEBASTIAN CONTI
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Credential | M.D.
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Telephone | 916-965-5050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2086S0129X
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Taxonomy Name | Vascular Surgery Physician
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License Number | G34056
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License Number State | CA
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