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General NPI Number Information
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NPI Number | 1699835777
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Entity Type | Organization
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Legal Business Name | SACRAMENTO GASTROENTEROLOGY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 3941 J STREET SUITE #450
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City | SACRAMENTO
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State | CA
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Zip | 95819
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Country | US
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Telephone | 916-454-0655
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Fax | 916-454-5702
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Provider Business Mailing Address
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Address Line | 3941 J STREET SUITE #450
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City | SACRAMENTO
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State | CA
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Zip | 95819
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Country | US
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Telephone | 916-454-0655
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Fax | 916-454-5702
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Authorized Official
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Title or Position | MANAGING PARTNER
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Name | DR. GAUTAM N GANDHI
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Credential | MD
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Telephone | 916-454-0655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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