Provider Demographics
NPI:1144593310
Name:OBSTETRIX MEDICAL GROUP OF SACRAMENTO, P.C.
Entity type:Organization
Organization Name:OBSTETRIX MEDICAL GROUP OF SACRAMENTO, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ASSISTANT SECRETARY
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:SANTANA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:800-243-3839
Mailing Address - Street 1:1301 CONCORD TER
Mailing Address - Street 2:
Mailing Address - City:SUNRISE
Mailing Address - State:FL
Mailing Address - Zip Code:33323-2843
Mailing Address - Country:US
Mailing Address - Phone:800-243-3839
Mailing Address - Fax:
Practice Address - Street 1:5301 F ST
Practice Address - Street 2:SUITE 207
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:95819
Practice Address - Country:US
Practice Address - Phone:916-733-7111
Practice Address - Fax:916-733-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-02-17
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VM0101XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyMaternal & Fetal MedicineGroup - Multi-Specialty