MEDICARE: PROFESSIONAL MEDICAL CLINIC FOR WOMEN-SACRAMENTO, INC.

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	207V00000X	Obstetrics & Gynecology Physician	G37098	CA

Other Identifiers

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

General Provider Information

NPI Number	:	1962519868
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PROFESSIONAL MEDICAL CLINIC FOR WOMEN-SACRAMENTO, INC.

Provider Business Mailing Address
First Line	:	7237 E SOUTHGATE DR
Second Line	:	SUITE C
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2637
Country	:	US
Telephone Number	:	916-392-2290
Fax Number	:	916-392-3706

Provider Business Practice Location Address
First Line	:	7237 E SOUTHGATE DR
Second Line	:	SUITE C
City	:	SACRAMENTO
State	:	CA
Zip	:	95823-2637
Country	:	US
Telephone Number	:	916-392-2290
Fax Number	:	916-392-3706

Authorized Official
Title or Position	:	OWNER/PHYSICIAN
Name	:	DR. NATHAN H ALLEN
Credential	:	M.D.
Telephone Number	:	916-392-2290

Provider Enumeration Date	:	08/24/2006
Last Update Date	:	02/14/2008

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Directions to “PROFESSIONAL MEDICAL CLINIC FOR WOMEN-SACRAMENTO, INC. ” Practice Location

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