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General NPI Number Information
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NPI Number | 1821239237
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Entity Type | Organization
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Legal Business Name | UNIVERSAL MEDICAL CLINIC, LLP
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Dates
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Enumeration Date | 03/13/2009
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Last Update Date | 03/13/2009
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Provider Practice Location Address
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Address Line | 7275 E SOUTHGATE DR STE 102
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City | SACRAMENTO
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State | CA
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Zip | 95823-2610
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Country | US
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Telephone | 916-519-0757
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Fax |
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Provider Business Mailing Address
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Address Line | 2330 FRUITRIDGE RD STE 3
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City | SACRAMENTO
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State | CA
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Zip | 95822-3156
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Country | US
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Telephone | 916-519-0757
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Fax |
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Authorized Official
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Title or Position | OWNER, CORPORATION PARTNER
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Name | DR. KENNY MUCHAHARIYAJ
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Credential |
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Telephone | 916-519-0757
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State | CA
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