Provider Demographics
NPI:1497822852
Name:SACRAMENTO BARIATRIC MEDICAL ASSOCIATES
Entity Type:Organization
Organization Name:SACRAMENTO BARIATRIC MEDICAL ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MACHADO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-965-2401
Mailing Address - Street 1:5769 GREENBACK LN
Mailing Address - Street 2:SUITE 1
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95841-2013
Mailing Address - Country:US
Mailing Address - Phone:916-338-7200
Mailing Address - Fax:916-338-7204
Practice Address - Street 1:5769 GREENBACK LN
Practice Address - Street 2:SUITE 1
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-2013
Practice Address - Country:US
Practice Address - Phone:916-338-7200
Practice Address - Fax:916-338-7204
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2009-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA62422208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CANP10336OtherNP LICENSE
CAH26267Medicare UPIN