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NPI Code Detail

MEDICARE: DAVID ROBERT SYDOW MD

MEDICARE: DAVID ROBERT SYDOW MD
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
1207L00000XAnesthesiology PhysicianG067635CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2G067635OTHERCALICENSE #

General Provider Information

NPI Number : 1427025931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID ROBERT SYDOW MD
Provider Business Mailing Address
First Line : 3116 W MARCH LN
Second Line : STE 200
City : STOCKTON
State : CA
Zip : 95219-2370
Country : US
Telephone Number : 209-473-6555
Fax Number : 209-473-6544
Provider Business Practice Location Address
First Line : 1100 BUTTE ST
Second Line :
City : REDDING
State : CA
Zip : 96001-0852
Country : US
Telephone Number : 530-241-0410
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/02/2006
Last Update Date : 03/07/2023

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