Organization
SACRAMENTO RADIOLOGY MEDICAL GROUP, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SIGRID OWYANG (EXECUTIVE DIRECTOR)
(916) 363-4040
Entity
Organization
Contact information
Practice address
1635 CREEKSIDE DR, SUITE 100, FOLSOM, CA 95630-3830
(916) 984-1866
(916) 984-1848
Mailing address
PO BOX 276010, SACRAMENTO, CA 95827-6010
(916) 363-4040
(916) 363-6715
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR001137Z
MEDI-CAL
CA
01
—
ZZZ26916Z
BLUE SHIELD
—
Enumeration date
05/09/2008
Last updated
05/09/2008
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