PHYSICIANS NETWORK MEDICAL GROUP INC (NPI# 1932477874) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932477874 |
| Entity Type | Organization |
| Organization Name | PHYSICIANS NETWORK MEDICAL GROUP INC |
| Practice Address |
2100 Douglas Blvd Roseville CA 95661-3804 |
| Practice Telephone | 9167894209 |
| Practice Fax Number | 9167894206 |
| Mailing Telephone | 9167894209 |
| Mailing Fax Number | 9167894206 |
| Enumeration Date | 2011-12-07 |
| Last Update Date | 2011-12-07 |
| Authorized Official Name | DAVID ORMEROD (MD/CEO) |
| Authorized Official Telephone | 9167894209 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities |
| Street Address |
2100 DOUGLAS BLVD |
| City | ROSEVILLE |
| State | CA |
| Zip Code | 95661-3804 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720306756 | Keith Raphael Doram | Internal Medicine | 2100 Douglas Blvd, Roseville, CA 95661-3804 | 2010-05-14 |
| 1265908032 | Adventist Health System / West | Religious Nonmedical Health Care Institution | 2100 Douglas Blvd, Roseville, CA 95661 | 2018-10-19 |
| 1982137287 | Anna Khananian | Specialist | 2100 Douglas Blvd, Roseville, CA 95661-3804 | 2017-04-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134777816 | Aprildawn Mccarty Mccarty | Behavior Technician | 2125 Professional Dr, 100, Roseville, CA 95661 | 2019-08-27 |
| 1407409089 | David Armel Gomez Croddy | Dentist | 2740 Carradale Drive, Roseville, CA 95661 | 2019-07-22 |
| 1699335612 | Mowell | Durable Medical Equipment & Medical Supplies | 901 Sunrise, Roseville, CA 95661 | 2019-06-20 |
| 1578024998 | Mystesia Lasan Hayes | Behavior Technician | 4121 Vittorio Dr., Roseville, CA 95661 | 2019-03-28 |
| 1033676457 | The Place Within | Counselor | 720 Sunrise Ave #d115, Roseville, CO 95661 | 2019-02-21 |
| 1396217733 | Tuyen Thi Thanh Nguyen | Respiratory Therapist, Registered | Kaiser Roseville Hospital, 1600 Eureka Rd, Roseville, CA 95661 | 2018-12-26 |
| 1982179776 | Dr. Jeffrey A. Saladin, Dental Corporation | Dentist | 1565 Eureka Road, Suite 5, Roseville, CA 95661 | 2018-10-08 |
| 1184106536 | Sabita Kondle | Marriage & Family Therapist | 1528 Hope Counseling Center Ste 101, Roseville, CA 95661 | 2018-09-02 |
| 1740787837 | Sylvia A Atieno | Nurse Practitioner | Suttter Roseville Medical Center, 1 Medical Plaza, Roseville, CA 95661 | 2018-04-06 |
| 1457875296 | Good Works Psychophysiology and Physical Therapy | Physical Therapist | 1650 Leadhill Blvd, 600, Roseville, CA 95661 | 2017-08-02 |
| Find all providers in zip 95661 | ||||
| Taxonomy Code | 261QM1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Multi-Specialty |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902219595 | Rosenberg Center: Assessment and Treatment for Children and Families | Clinic/Center | 1935 County Road B2 W, Suite 100, Roseville, MN 55113-2729 | 2014-06-11 |
| 1912031477 | Dignity Health Medical Foundation | Clinic/Center | 2110 Professional Dr, Suite 120, Roseville, CA 95661-3752 | 2007-03-15 |
| 1144200775 | Regents of The University of California | Clinic/Center | 2261 Douglas Blvd, Roseville, CA 95661-3831 | 2006-01-19 |
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| Find all providers with the same taxonomy | ||||
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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.