Provider Demographics
NPI:1033142658
Name:KNIGHT, OREL H (MD)
Entity Type:Individual
Prefix:
First Name:OREL
Middle Name:H
Last Name:KNIGHT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 F ST
Mailing Address - Street 2:#318
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3226
Mailing Address - Country:US
Mailing Address - Phone:916-733-1740
Mailing Address - Fax:916-733-1719
Practice Address - Street 1:5301 F ST
Practice Address - Street 2:#318
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3226
Practice Address - Country:US
Practice Address - Phone:916-733-1740
Practice Address - Fax:916-733-1719
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA32526174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA32526OtherCA LIC
00A325260Medicare ID - Type Unspecified