Provider Demographics
NPI:1770673394
Name:PUGLIA, KATHLEEN (MD)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:PUGLIA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:916-731-7877
Practice Address - Street 1:2801 K ST
Practice Address - Street 2:SUITE 502
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95816-5120
Practice Address - Country:US
Practice Address - Phone:877-515-0053
Practice Address - Fax:916-454-6926
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2019-03-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
UT4831483-12052085R0202X
CAA1029772085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0A1029774Medicare PIN