| Roseville Pediatric Medical Group, Inc | |
|
1098 Sunrise Ave Ste 100 Roseville CA 95661-4469 | |
| (916) 789-1798 | |
| (916) 789-0889 |
| Full Name | Roseville Pediatric Medical Group, Inc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 1098 Sunrise Ave Ste 100, Roseville, California |
| Authorized Official Name and Position | Jennell Mae Serda (MANAGER) |
| Authorized Official Contact | 9167891798 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Roseville Pediatric Medical Group, Inc 1098 Sunrise Ave Ste 100 Roseville CA 95661-4469 Ph: (916) 789-1798 | Roseville Pediatric Medical Group, Inc 1098 Sunrise Ave Ste 100 Roseville CA 95661-4469 Ph: (916) 789-1798 |
| NPI Number | 1275647737 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 09/17/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275647737 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 029336 (California) | Primary |
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