Organization
EAST SACRAMENTO PEDIATRIC MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAVINDER SINGH KHAIRA MD (OWNER/PHYSICIAN)
(916) 451-8430
Entity
Organization
Contact information
Practice address
5030 J ST STE 301, SACRAMENTO, CA 95819-3800
(916) 451-8430
Mailing address
5030 J ST STE 301, SACRAMENTO, CA 95819-3800
(916) 451-8430
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1588600431
—
CA
05
—
1811383490
—
CA
05
—
1902842354
—
CA
Enumeration date
12/19/2019
Last updated
12/19/2019
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