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1255338695

NPI Code Detail

MEDICARE: DR. SUSAN W SOMPAYRAC M.D.

MEDICARE: DR. SUSAN W SOMPAYRAC M.D.

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	2085B0100X	Body Imaging Physician	G81006	CA
2	2085N0700X	Neuroradiology Physician	G81006	CA
3	2085N0904X	Nuclear Radiology Physician	G81006	CA
4	2085R0202X	Diagnostic Radiology Physician	G81006	CA
5	2085R0203X	Therapeutic Radiology Physician	G81006	CA
6	2085R0204X	Vascular & Interventional Radiology Physician	G81006	CA
7	2085R0205X	Radiological Physics Physician	G81006	CA
8	2085U0001X	Diagnostic Ultrasound Physician	G81006	CA

General Provider Information

NPI Number	:	1255338695
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUSAN W SOMPAYRAC M.D.

Provider Business Mailing Address
First Line	:	10470 OLD PLACERVILLE RD
Second Line	:	SUITE 100
City	:	SACRAMENTO
State	:	CA
Zip	:	95827-2539
Country	:	US
Telephone Number	:	800-470-0071
Fax Number	:

Provider Business Practice Location Address
First Line	:	3161 L ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95816-5234
Country	:	US
Telephone Number	:	916-453-9999
Fax Number	:	916-739-1099

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	07/22/2015

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Directions to “ DR. SUSAN W SOMPAYRAC M.D.” Practice Location

Language	Start Address	Practice Location

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