Provider Demographics
NPI:1497776603
Name:PALUMBO, FRANK C
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:C
Last Name:PALUMBO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 WYNDGATE RD
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864-5944
Mailing Address - Country:US
Mailing Address - Phone:916-482-8283
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST
Practice Address - Street 2:ACC #3800
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-5885
Practice Address - Fax:916-734-7904
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC30047207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C300470Medicaid
CAA34105Medicare UPIN
CA00C300470Medicare ID - Type Unspecified