MEDICARE: DR. JULIE GENG 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	A88051	CA

General Provider Information

NPI Number	:	1851377741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JULIE GENG M.D.

Provider Business Mailing Address
First Line	:	645 41ST ST
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95819-2735
Country	:	US
Telephone Number	:	916-346-8102
Fax Number	:	916-734-6548

Provider Business Practice Location Address
First Line	:	4860 Y ST
Second Line	:	#3100
City	:	SACRAMENTO
State	:	CA
Zip	:	95817-2307
Country	:	US
Telephone Number	:	916-734-6533
Fax Number	:	916-734-6548

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

Provider Enumeration Date	:	12/21/2005
Last Update Date	:	04/14/2008

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