Provider Demographics
NPI:1114306289
Name:SACRAMENTO SKILLED NURSING AND LONG TERM CARE MEDICAL GROUP INC.
Entity Type:Organization
Organization Name:SACRAMENTO SKILLED NURSING AND LONG TERM CARE MEDICAL GROUP INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF MEDICAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:FIKIR
Authorized Official - Middle Name:
Authorized Official - Last Name:MORKOC
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:530-320-6227
Mailing Address - Street 1:P.O.BOX 163090
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95816
Mailing Address - Country:US
Mailing Address - Phone:530-320-6227
Mailing Address - Fax:916-538-6056
Practice Address - Street 1:1133 42 ND STREET
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819
Practice Address - Country:US
Practice Address - Phone:530-320-6227
Practice Address - Fax:916-538-6056
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-22
Last Update Date:2015-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG79846207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty