Provider Demographics
NPI:1841240454
Name:SACRAMENTO CARDIOVASCULAR SURGEONS MEDICAL GROUP INC
Entity Type:Organization
Organization Name:SACRAMENTO CARDIOVASCULAR SURGEONS MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:L
Authorized Official - Last Name:LOESCHER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-451-5602
Mailing Address - Street 1:5301 F ST
Mailing Address - Street 2:STE 111
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95819-3226
Mailing Address - Country:US
Mailing Address - Phone:916-452-8291
Mailing Address - Fax:916-452-1733
Practice Address - Street 1:5301 F ST
Practice Address - Street 2:STE 111
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95819-3226
Practice Address - Country:US
Practice Address - Phone:916-452-8291
Practice Address - Fax:916-452-1733
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2010-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantGroup - Multi-Specialty