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Organization
SACRAMENTO KNEE & SPORTS MEDICINE
Active
Organization
SACRAMENTO KNEE & SPORTS MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EVELYN L RODRIGUEZ (FINANCIAL ADMINISTRATOR)
(916) 454-6677
Entity
Organization
Contact information
Practice address
2801 K ST STE 310, SACRAMENTO, CA 95816
(916) 454-6677
(916) 733-8741
Mailing address
2801 K ST STE 310, SACRAMENTO, CA 95816-5119
(916) 389-7977
(916) 389-7951
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
NULL
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
NULL
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
NULL
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
363A00000X
Physician Assistant
—
NULL
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
—
NULL
363AM0700X
Medical Physician Assistant
—
—
363AS0400X
Surgical Physician Assistant
—
NULL
363AS0400X
Surgical Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
170865900
US DEPT OF LABOR
CA
05
—
GR0064540
—
CA
01
—
ZZZ00355Z
BLUE SHIELD OF CALIF
CA
Enumeration date
08/23/2006
Last updated
01/13/2026
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