Organization
SACRAMENTO ORTHOPEDIC SPORTS & SHOULDER
Active
Organization
SACRAMENTO ORTHOPEDIC SPORTS & SHOULDER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GREG TAKENISHI MD (CHIEF EXCECUTIVE OFFICER)
(414) 807-0645
Entity
Organization
Contact information
Practice address
2801 K ST STE 330, SACRAMENTO, CA 95816-5119
(414) 807-0645
Mailing address
2801 K ST STE 330, SACRAMENTO, CA 95816-5119
(916) 732-3000
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
Other
Enumeration date
06/01/2023
Last updated
06/01/2023
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