Provider Demographics
NPI:1427413772
Name:WEST SAC MEDICAL GROUP INC
Entity Type:Organization
Organization Name:WEST SAC MEDICAL GROUP INC
Other - Org Name:WEST SACRAMENTO URGENT CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ZIAD
Authorized Official - Middle Name:
Authorized Official - Last Name:ALI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-617-2377
Mailing Address - Street 1:2455 JEFFERSON BLVD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:WEST SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95691-5313
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2455 JEFFERSON BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:WEST SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95691-5313
Practice Address - Country:US
Practice Address - Phone:916-617-2377
Practice Address - Fax:916-680-8065
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care