| Regents Ucdpbg Im Nutrition | |
|
4860 Y St Sacramento CA 95817-2307 | |
| (916) 734-8046 | |
| (916) 734-2732 |
| Full Name | Regents Ucdpbg Im Nutrition |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 4860 Y St, Sacramento, California |
| Authorized Official Name and Position | William H Mcgowan (CFO) |
| Authorized Official Contact | 9167349129 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Regents Ucdpbg Im Nutrition 4900 Broadway Suite 2600 Sacramento CA 95820-1532 Ph: (916) 734-9200 | Regents Ucdpbg Im Nutrition 4860 Y St Sacramento CA 95817-2307 Ph: (916) 734-8046 |
| NPI Number | 1891777876 |
|---|---|
| Provider Enumeration Date | 11/16/2005 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891777876 | NPI | - | NPPES |
| GRW02104A | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
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