Organization
SACRAMENTO STREET MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY MENACHO PA-C (EXECUTIVE DIRECTOR)
(909) 730-5241
Entity
Organization
Contact information
Practice address
2211 DEL PASO BLVD, SACRAMENTO, CA 95815-3101
(916) 720-2237
(800) 815-8510
Mailing address
2917 GRAYSON WAY, RANCHO CORDOVA, CA 95670
(916) 800-4054
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
2083P0901X
Public Health & General Preventive Medicine Physician
Primary
—
—
Other
Enumeration date
08/23/2022
Last updated
12/17/2024
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