Organization
CAPITOL UROLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIUMARS R HEKMAT M.D. (PHYSICIAN)
(916) 921-4529
Entity
Organization
Contact information
Practice address
500 UNIVERSITY AVE, SUITE 200, SACRAMENTO, CA 95825-6504
(916) 921-4530
(916) 924-1611
Mailing address
500 UNIVERSITY AVE, SUITE 200, SACRAMENTO, CA 95825-6504
(916) 921-4530
(916) 924-1611
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
A37811
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GR0065840
—
CA
Enumeration date
08/07/2006
Last updated
08/15/2008
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