Provider Demographics
NPI:1578218335
Name:INTEGRITYMD INC
Entity Type:Organization
Organization Name:INTEGRITYMD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:NNENNA
Authorized Official - Middle Name:N
Authorized Official - Last Name:IKEGBU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-834-7915
Mailing Address - Street 1:2912 SIENNA LN
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95864
Mailing Address - Country:US
Mailing Address - Phone:347-834-7915
Mailing Address - Fax:
Practice Address - Street 1:1001 NUT TREE RD STE 110
Practice Address - Street 2:
Practice Address - City:VACAVILLE
Practice Address - State:CA
Practice Address - Zip Code:95687-4166
Practice Address - Country:US
Practice Address - Phone:347-834-7915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-02-19
Last Update Date:2022-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty