Basic Information
| Provider Information | |||||||||
| NPI: | 1700069549 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ACUTE CARE SURGERY MEDICAL GROUP, INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 398102 | ||||||||
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| City: | SAN FRANCISCO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 941398102 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164410400 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2800 L ST | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | SACRAMENTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 958165616 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9164410400 | ||||||||
| FaxNumber: | 9164546523 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/16/2007 | ||||||||
| LastUpdateDate: | 11/17/2020 | ||||||||
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| AuthorizedOfficialLastName: | REED | ||||||||
| AuthorizedOfficialFirstName: | SEAN | ||||||||
| AuthorizedOfficialMiddleName: | M. | ||||||||
| AuthorizedOfficialTitleorPosition: | COUNSEL | ||||||||
| AuthorizedOfficialTelephone: | 9164410400 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | JD | ||||||||
| NPICertificationDate: | 11/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 2086S0102X | 3056079 | CA | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care | 2086S0127X | 3056079 | CA | N | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Trauma Surgery | 208600000X | 3056079 | CA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.