Provider Demographics
NPI:1922195189
Name:NATOMAS FAMILY PRACTICE
Entity Type:Organization
Organization Name:NATOMAS FAMILY PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:HWANG
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-928-0856
Mailing Address - Street 1:2400 DEL PASO RD
Mailing Address - Street 2:STE. 145
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-9627
Mailing Address - Country:US
Mailing Address - Phone:916-928-0856
Mailing Address - Fax:916-928-1754
Practice Address - Street 1:2400 DEL PASO RD
Practice Address - Street 2:STE. 145
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-9627
Practice Address - Country:US
Practice Address - Phone:916-928-0856
Practice Address - Fax:916-928-1754
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A80820207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ30859ZMedicare ID - Type Unspecified