MEDICARE: DR. DEANNE MARIE NYLAND 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
1	207Y00000X	Otolaryngology Physician	A123960	CA

General Provider Information

NPI Number	:	1538332176
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEANNE MARIE NYLAND MD

Provider Business Mailing Address
First Line	:	1111 EXPOSITION BLVD BLDG 700
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95815-4314
Country	:	US
Telephone Number	:	916-736-3399
Fax Number	:

Provider Business Practice Location Address
First Line	:	6600 MERCY CT STE 180A
Second Line	:
City	:	FAIR OAKS
State	:	CA
Zip	:	95628-3198
Country	:	US
Telephone Number	:	916-966-2700
Fax Number	:	916-966-0749

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

Provider Enumeration Date	:	04/03/2008
Last Update Date	:	06/10/2024

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