=====================================================
General NPI Number Information
=====================================================
NPI Number | 1700478211
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SACHIN ANUJEET SINGH FNP
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/05/2021
-----------------------------------------------------
Last Update Date | 01/04/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 520 9TH ST STE 240
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95814-1327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-558-4747
-----------------------------------------------------
Fax | 916-404-5556
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 520 9TH ST STE 240
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95814-1327
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 888-558-4747
-----------------------------------------------------
Fax | 916-404-5556
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Nurse Practitioner
-----------------------------------------------------
License Number | 95015255
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------