Provider Demographics
NPI:1891701165
Name:SACRAMENTO IMAGING, INC.
Entity Type:Organization
Organization Name:SACRAMENTO IMAGING, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMA
Authorized Official - Middle Name:
Authorized Official - Last Name:DERMISHYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-752-7750
Mailing Address - Street 1:6608 MERCY CT
Mailing Address - Street 2:SUITE B
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-3133
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:6608 MERCY CT
Practice Address - Street 2:SUITE B
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-3133
Practice Address - Country:US
Practice Address - Phone:916-965-1833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0200XAmbulatory Health Care FacilitiesClinic/CenterRadiology