# SACRAMENTO KNEE & SPORTS MEDICINE

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1922115575
- **Authorized official:** EVELYN L RODRIGUEZ (FINANCIAL ADMINISTRATOR)
- **Authorized official phone:** (916) 454-6677

## Contact information

- **Practice address:** 2801 K ST STE 310, SACRAMENTO, CA 95816
- **Practice address phone:** (916) 454-6677
- **Practice address fax:** (916) 733-8741
- **Mailing address:** 2801 K ST STE 310, SACRAMENTO, CA 95816-5119
- **Mailing address phone:** (916) 389-7977
- **Mailing address fax:** (916) 389-7951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | — | NULL | Yes |
| 207X00000X | Orthopaedic Surgery Physician | — | — | Yes |
| 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

- **Enumeration date:** 08/23/2006
- **Last updated:** 01/13/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 170865900 | US DEPT OF LABOR | CA |
| 05 | — | GR0064540 | — | CA |
| 01 | — | ZZZ00355Z | BLUE SHIELD OF CALIF | CA |