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General NPI Number Information
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NPI Number | 1801267604
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Entity Type | Organization
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Legal Business Name | FAMILY PSYCHIATRY CENTER INC
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Dates
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Enumeration Date | 10/19/2015
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Last Update Date | 10/19/2015
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Provider Practice Location Address
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Address Line | 8009 BRUCEVILLE RD STE 102
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City | SACRAMENTO
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State | CA
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Zip | 95823-2332
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Country | US
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Telephone | 916-716-4148
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Fax |
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Provider Business Mailing Address
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Address Line | 10067 WYATT RANCH WAY
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City | SACRAMENTO
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State | CA
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Zip | 95829-8003
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | ALOK BANGA
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Credential | MD
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Telephone | 916-716-4148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A131310
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License Number State | CA
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