Basic Information
| Provider Information | |||||||||
| NPI: | 1275869406 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | RADIOLOGICAL ASSOCIATES OF SACRAMENTO MEDICAL GROUP INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1500 EXPO PKWY | ||||||||
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| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958154227 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9166468326 | ||||||||
| FaxNumber: | 9169204434 | ||||||||
| Practice Location | |||||||||
| Address1: | 7500 HOSPITAL DR | ||||||||
| Address2: | |||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958235403 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164233000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 10/22/2009 | ||||||||
| LastUpdateDate: | 10/22/2009 | ||||||||
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| AuthorizedOfficialLastName: | GASCHEN | ||||||||
| AuthorizedOfficialFirstName: | FRED | ||||||||
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| AuthorizedOfficialTitleorPosition: | EXECUTIVE VICE PRESENT | ||||||||
| AuthorizedOfficialTelephone: | 9166468300 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0003X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology |
No ID Information.