=====================================================
General NPI Number Information
=====================================================
NPI Number | 1811377062
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN HARRISON HOWARD III M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/03/2015
-----------------------------------------------------
Last Update Date | 06/13/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2218 KAUSEN DR STE 103
-----------------------------------------------------
City | ELK GROVE
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95758-7178
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-683-8774
-----------------------------------------------------
Fax | 916-683-8777
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1111 EXPOSITION BLVD STE 300
-----------------------------------------------------
City | SACRAMENTO
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 95815-4324
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 916-929-8564
-----------------------------------------------------
Fax | 916-929-4529
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207RN0300X
-----------------------------------------------------
Taxonomy Name | Nephrology Physician
-----------------------------------------------------
License Number | A156404
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------