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General NPI Number Information
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NPI Number | 1700658184
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Entity Type | Organization
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Legal Business Name | NATOMAS LASER & AESTHETICS
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Dates
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Enumeration Date | 10/27/2023
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Last Update Date | 10/27/2023
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Provider Practice Location Address
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Address Line | 4450 DUCKHORN DR STE B
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City | SACRAMENTO
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State | CA
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Zip | 95834-2596
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Country | US
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Telephone | 916-898-1810
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Fax | 916-333-2677
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Provider Business Mailing Address
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Address Line | 4450 DUCKHORN DR STE B
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City | SACRAMENTO
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State | CA
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Zip | 95834-2596
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Country | US
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Telephone | 916-898-1810
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Fax | 916-333-2677
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Authorized Official
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Title or Position | OWNER
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Name | GERALDINE SULIMAN
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Credential | PHYSICIAN ASSISTANT
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Telephone | 916-898-1810
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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