| Gregory G Smith M D A Professional Corporation | |
|
7600 Hospital Dr Ste G Sacramento CA 95823-5406 | |
| (916) 688-3181 | |
| (916) 688-3215 |
| Full Name | Gregory G Smith M D A Professional Corporation |
|---|---|
| Speciality | Internal Medicine |
| Location | 7600 Hospital Dr Ste G, Sacramento, California |
| Authorized Official Name and Position | Gregory G. Smith (PRESIDENT) |
| Authorized Official Contact | 9166883181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Gregory G Smith M D A Professional Corporation Po Box 162267 Sacramento CA 95816-2267 Ph: (916) 688-3181 | Gregory G Smith M D A Professional Corporation 7600 Hospital Dr Ste G Sacramento CA 95823-5406 Ph: (916) 688-3181 |
| NPI Number | 1124215348 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 03/18/2013 |
| Medicare PECOS PAC ID | 8527136084 |
|---|---|
| Medicare Enrollment ID | O20081010000186 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1124215348 | NPI | - | NPPES |
| 1952322596 | Other | CA | INDIVIDUAL NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | William C Ta |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790955300 PECOS PAC ID: 5597902106 Enrollment ID: I20130517000485 |
| Provider Name | David J Kyle |
|---|---|
| Provider Type | Practitioner - Osteopathic Manipulative Medicine |
| Provider Identifiers | NPI Number: 1952531758 PECOS PAC ID: 9638472194 Enrollment ID: I20160118000764 |
| Provider Name | Lashunda Kelley Phillips |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1477962595 PECOS PAC ID: 9436371275 Enrollment ID: I20160920002707 |
| Provider Name | George Madera |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1811904873 PECOS PAC ID: 3779574439 Enrollment ID: I20201125000513 |
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