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General NPI Number Information
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NPI Number | 1871759431
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Entity Type | Organization
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Legal Business Name | SIERRA IMMEDIATE CARE MEDICAL CENTER
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Dates
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Enumeration Date | 08/04/2008
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Last Update Date | 09/25/2008
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Provider Practice Location Address
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Address Line | 1000 FOWLER WAY SUITE #7
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City | PLACERVILLE
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State | CA
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Zip | 95667-5738
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Country | US
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Telephone | 530-295-1074
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Fax | 530-295-0328
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Provider Business Mailing Address
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Address Line | 1000 FOWLER WAY SUITE #7
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City | PLACERVILLE
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State | CA
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Zip | 95667-5738
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Country | US
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Telephone | 530-295-1074
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Fax | 530-295-0328
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Authorized Official
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Title or Position | OWNER
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Name | DR. PAUL B SOBELMAN
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Credential | M.D.
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Telephone | 530-295-1074
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | FNP 31014
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License Number State | CA
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