Provider Demographics
NPI:1255342085
Name:ADAMS, SALLIE O (MD)
Entity type:Individual
Prefix:DR
First Name:SALLIE
Middle Name:O
Last Name:ADAMS
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:10470 OLD PLACERVILLE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95827-2539
Mailing Address - Country:US
Mailing Address - Phone:800-470-0071
Mailing Address - Fax:
Practice Address - Street 1:3100 DOUGLAS BLVD
Practice Address - Street 2:SUTIE 204
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-3866
Practice Address - Country:US
Practice Address - Phone:916-774-8885
Practice Address - Fax:916-774-8818
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2015-07-22
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Provider Licenses
StateLicense IDTaxonomies
CAG47124207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G471240Medicaid
CA00G471240Medicare ID - Type Unspecified
CAA50602Medicare UPIN