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
6620 COYLE AVE, SUITE 107, CARMICHAEL, CA 95608-6333
(916) 961-6920
Mailing address
6620 COYLE AVE, SUITE 107, CARMICHAEL, CA 95608-6333
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0011372
MEDI-CAL
CA
01
—
ZZZ17567Z
BLUE SHIELD
—
Enumeration date
05/14/2008
Last updated
05/14/2008
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