Provider Demographics
NPI:1073074159
Name:CEDAR TREE HOLDINGS CO.
Entity Type:Organization
Organization Name:CEDAR TREE HOLDINGS CO.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:ALFEAR
Authorized Official - Middle Name:NELSON
Authorized Official - Last Name:WRIGHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-969-2480
Mailing Address - Street 1:10017 FEDERALIST LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1934
Mailing Address - Country:US
Mailing Address - Phone:916-969-2480
Mailing Address - Fax:888-471-7469
Practice Address - Street 1:10017 FEDERALIST LN
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1934
Practice Address - Country:US
Practice Address - Phone:800-827-5926
Practice Address - Fax:888-471-7469
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-29
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAC4104649OtherCORPORATION ENTITY NUMBER