MEDICARE: SYLVIA JARAMILLO ORTEGA P.A.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207N00000X	Dermatology Physician	PA19187	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215124946
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SYLVIA JARAMILLO ORTEGA P.A.

Provider Business Mailing Address
First Line	:	8735 SIERRA COLLEGE BLVD
Second Line	:	SUITE 200
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-5992
Country	:	US
Telephone Number	:	916-773-3376
Fax Number	:	916-773-3353

Provider Business Practice Location Address
First Line	:	8735 SIERRA COLLEGE BLVD
Second Line	:	SUITE 200
City	:	ROSEVILLE
State	:	CA
Zip	:	95661-5992
Country	:	US
Telephone Number	:	916-773-3376
Fax Number	:	916-773-3353

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2007
Last Update Date	:	02/28/2014

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