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Organization
COUNTY OF SACRAMENTO
Active
Organization
COUNTY OF SACRAMENTO
Active
Parent organization
COUNTY OF SACRAMENTO
Other names
Chest Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SACRAMENTO
Authorized official
MRS. QUAITA L. STUCKER (SENIOR ACCOUNT CLERK)
(916) 875-1416
Entity
Organization
Contact information
Practice address
4600 BROADWAY STE 1300, SACRAMENTO, CA 95820-1527
(916) 874-9823
(916) 874-9442
Mailing address
7001-A EAST PARKWAY STE. 600, SACRAMENTO, CA 95823-2501
(916) 875-5881
(916) 875-6366
Taxonomy
Speciality
Code
Description
License number
State
261QR0200X
Radiology Clinic/Center
05D0616630
CA
261QR0200X
Radiology Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05D0616630
CLIA NUMBER
CA
05
—
EXE70041F
—
CA
05
—
ZZR11521F
—
CA
Enumeration date
11/09/2006
Last updated
04/25/2019
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