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NPI Code Detail

MEDICARE: RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP

MEDICARE: RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP
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
1207UN0901XNuclear Cardiology Physician
2207UN0902XNuclear Imaging & Therapy PhysicianCA
3207UN0903XIn Vivo & In Vitro Nuclear Medicine PhysicianCA
4207U00000XNuclear Medicine PhysicianCA

Other Identifiers

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

General Provider Information

NPI Number : 1902887011
Entity Type Code : Organization
Provider Name (Legal Business Name) : RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP
Provider Business Mailing Address
First Line : 1500 EXPO PKWY
Second Line :
City : SACRAMENTO
State : CA
Zip : 95815-4227
Country : US
Telephone Number : 916-646-8406
Fax Number : 916-920-4434
Provider Business Practice Location Address
First Line : 11815 EDUCATION ST
Second Line :
City : AUBURN
State : CA
Zip : 95602-2410
Country : US
Telephone Number : 530-888-4535
Fax Number : 530-889-6095
Authorized Official
Title or Position : EXECUTIVE VICE PRESIDENT
Name : FRED GASCHEN
Credential :
Telephone Number : 916-646-8300
Provider Enumeration Date : 11/07/2005
Last Update Date : 09/28/2007

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