DR. RUBEN CORRAL FRAGOSO (NPI# 1417154436) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417154436 |
| Entity Type | Individual |
| Full Name | DR. RUBEN CORRAL FRAGOSO |
| Credential | MD, PHD |
| Practice Address |
4501 X St Suite 0156 Sacramento CA 95817-2229 |
| Mailing Address |
600 11th St Apt. #8 Sacramento CA 95814-0838 |
| Practice Telephone | 9167348276 |
| Practice Fax Number | 9167035069 |
| Mailing Telephone | 6178694409 |
| Mailing Fax Number | 9167035069 |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2009-08-05 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
MT187129 | PA | Allopathic & Osteopathic Physicians |
| Street Address |
4501 X ST SUITE 0156 |
| City | SACRAMENTO |
| State | CA |
| Zip Code | 95817-2229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801889068 | Regents of The Univ of Ca | Surgery | 4501 X St, Sacramento, CA 95817-2229 | 2005-08-23 |
| 1588289250 | Kathryn Laura Gayhart | Nurse Practitioner | 4501 X St, Sacramento, CA 95817-2229 | 2020-06-09 |
| 1043789159 | Laura Galindo | Nurse Practitioner | 4501 X St, Sacramento, CA 95817-2229 | 2018-11-19 |
| 1427533249 | Danielle L Baham | Dietitian, Registered | 4501 X St, Sacramento, CA 95817-2229 | 2018-09-27 |
| 1811444961 | Alana Laraine Rothman | Nurse Practitioner | 4501 X St, Sacramento, CA 95817-2229 | 2016-09-07 |
| 1700257672 | Tara Martinez | Nurse Practitioner | 4501 X St, 2nd Floor, Sacramento, CA 95817-2229 | 2015-10-16 |
| 1982086567 | Kristine Ahlberg | Registered Nurse | 4501 X St, Sacramento, CA 95817-2229 | 2015-06-19 |
| 1811377963 | Brian Pham | Internal Medicine | 4501 X St, Sacramento, CA 95817-2229 | 2015-06-04 |
| 1285011254 | Ky Nam Bao Nguyen | Radiology | 4501 X St, G140, Sacramento, CA 95817-2229 | 2015-04-29 |
| 1366849929 | Iris Chen Zhao | Pharmacist | 4501 X St, Room 2054, Sacramento, CA 95817-2229 | 2014-11-25 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346855103 | Quintin Kuse | Student in an Organized Health Care Education/Training Program | 4610 X Street, Sacramento, Sacramento, CA 95817 | 2020-09-09 |
| 1285259283 | Uc Davis Health | Dietitian, Registered | 2315 Stockton Blvd Sesp 0160, Sacramento, CA 95817 | 2020-06-15 |
| 1942840558 | Michael Marchand-gareau | Ophthalmology | Michael Marchand - Uc Davis Eye Center, 4860 Y Street, Suite 2400, Sacramento, CA 95817 | 2020-01-11 |
| 1467010728 | Jiunn Liang Jonathan Yap | Student in an Organized Health Care Education/Training Program | 4860 Y Str, Ste. 2820, Sacramento, CA 95817 | 2019-06-03 |
| 1083176614 | Kevin Lee | Student in an Organized Health Care Education/Training Program | 2315 Stockton Blvd, Op512, Sacramento, CA 95817 | 2019-04-02 |
| 1508326703 | Ritika Johal | Student in an Organized Health Care Education/Training Program | 4150 V Street, Pssb 1200, Sacramento, CA 95817 | 2019-03-22 |
| 1811468838 | Paige Palsgaard | Behavior Technician | 6730 4th Ave Apt 1731d, Sacramento, CA 95817 | 2018-12-17 |
| 1922503408 | Marie Rossi | Student in an Organized Health Care Education/Training Program | 4150 V Street #1100, Sacramento, CA 95817 | 2018-03-27 |
| 1639673791 | Sean Lam | Student in an Organized Health Care Education/Training Program | 4150 V Street #1200, Sacramento, CA 95817 | 2018-03-22 |
| 1124555388 | Tatyana Polyak | Surgery | 2335 Stockton Blvd., Naob 6th Floor, Sacramento, CA 95817 | 2017-05-18 |
| Find all providers in zip 95817 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619136835 | Arta Monir Monjazeb | Radiology | 4501 X Street, G120, Uc Davis Health System Department of Radiation Oncology, Sacramento, CA 95817-0000 | 2008-06-03 |
| 1780863340 | Megan Eileen Daly | Radiology | 4501 X St # G140, Department of Radiation Oncology, Sacramento, CA 95817-2229 | 2007-10-31 |
| 1235148495 | Vincent John Lee | Radiology | 8100 Bruceville Rd, Sacramento, CA 95823-2353 | 2006-08-05 |
| 1235152232 | Richard K. Valicenti | Radiology | 4501 X Street, Ground Floor, Sacramento, CA 95817-2229 | 2006-07-25 |
| 1457334534 | Tony S Quang | Radiology | 4501 X St Ste 0140, Sacramento, CA 95817-2229 | 2005-11-22 |
| 1164420808 | Harvey Brian Wolkov | Radiology | 2800 L St, Sacramento, CA 95816-5616 | 2005-07-07 |
| 1952308041 | Garrick Chi-rey Chang | Radiology | 2801 K St Ste 502, Sacramento, CA 95816-5119 | 2005-07-05 |
| 1669479853 | Mark David Logsdon | Radiology | 2825 Capitol Ave Ste 502, Sacramento, CA 95816 | 2005-07-01 |
| 1710983358 | Susan Weishenn Lee | Radiology | 4001 J St, Sacramento, CA 95819-3626 | 2005-06-27 |
| 1285011254 | Ky Nam Bao Nguyen | Radiology | 4501 X St, G140, Sacramento, CA 95817-2229 | 2015-04-29 |
| Find all providers in SACRAMENTO | ||||
| City | SACRAMENTO |
| Zip Code | 95817 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.