Sumon Johnson, NP | |
2570 48th St, Sacramento, CA 95817-1541 | |
(916) 734-2145 | |
Not Available |
Full Name | Sumon Johnson |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 2570 48th St, Sacramento, California |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1003542143 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | NP95017865 (California) | Primary |
Entity Name | Peach Tree Healthcare |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1003863622 PECOS PAC ID: 7416978440 Enrollment ID: O20101104000566 |
Mailing Address | Practice Location Address |
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Sumon Johnson, NP 2570 48th St, Sacramento, CA 95817-1541 Ph: (916) 734-2145 | Sumon Johnson, NP 2570 48th St, Sacramento, CA 95817-1541 Ph: (916) 734-2145 |
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