Provider Demographics
NPI:1013020783
Name:SAZIMA, GREGORY CHARLES (MD)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:CHARLES
Last Name:SAZIMA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1899 EAST ROSEVILLE PARKWAY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ROSEVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:95661-7980
Mailing Address - Country:US
Mailing Address - Phone:916-797-2248
Mailing Address - Fax:916-797-2289
Practice Address - Street 1:1899 EAST ROSEVILLE PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-7980
Practice Address - Country:US
Practice Address - Phone:916-797-2248
Practice Address - Fax:916-797-2289
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2017-11-16
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG0685872084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE91496Medicare UPIN