Provider Demographics
NPI:1831141316
Name:MACHADO, LAURA LEE (MD)
Entity Type:Individual
Prefix:DR
First Name:LAURA
Middle Name:LEE
Last Name:MACHADO
Suffix:
Gender:F
Credentials:MD
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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
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2011-06-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA62422208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA32-0014044OtherTAX ID#
CA77-0600204OtherTAX ID#
CAH26267Medicare UPIN