Provider Demographics
NPI:1942478615
Name:MICHAEL G. ADELBERG, A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:MICHAEL G. ADELBERG, A PROFESSIONAL CORPORATION
Other - Org Name:ADELBERG ASSOCIATES MEDICAL GROUP
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DEBBY
Authorized Official - Middle Name:GILZEAN
Authorized Official - Last Name:ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-362-5112
Mailing Address - Street 1:9856 BUSINESS PARK DR
Mailing Address - Street 2:SUITE I
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-1741
Mailing Address - Country:US
Mailing Address - Phone:916-362-5112
Mailing Address - Fax:916-362-6115
Practice Address - Street 1:9856 BUSINESS PARK DR
Practice Address - Street 2:SUITE I
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-1741
Practice Address - Country:US
Practice Address - Phone:916-362-5112
Practice Address - Fax:916-362-6115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-15
Last Update Date:2008-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG367970204D00000X
207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMMGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty