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General NPI Number Information
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NPI Number | 1801072897
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Entity Type | Individual
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Provider Name | EMMANUEL PANAGIOTIS BAKIS JR. DPT
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Gender | Male
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Dates
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Enumeration Date | 01/21/2008
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1201 ALHAMBRA BLVD STE 200
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City | SACRAMENTO
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State | CA
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Zip | 95816-5241
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Country | US
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Telephone | 916-731-7900
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Fax | 916-731-7915
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Provider Business Mailing Address
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Address Line | 10470 OLD PLACERVILLE RD STE 100
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City | SACRAMENTO
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State | CA
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Zip | 95827-2539
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Country | US
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Telephone | 800-470-0071
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 34030
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT34030
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License Number State | CA
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