Provider Demographics
NPI:1740255488
Name:NORCAL DIAGNOSTICS
Entity type:Organization
Organization Name:NORCAL DIAGNOSTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:T
Authorized Official - Last Name:YATES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-681-9470
Mailing Address - Street 1:7600 HOSPITAL DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5406
Mailing Address - Country:US
Mailing Address - Phone:916-681-9470
Mailing Address - Fax:916-681-0411
Practice Address - Street 1:7600 HOSPITAL DR
Practice Address - Street 2:SUITE E
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5406
Practice Address - Country:US
Practice Address - Phone:916-681-9470
Practice Address - Fax:916-681-0411
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-02-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA103531332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ25380ZMedicare ID - Type UnspecifiedIDTF
CA866-899-5227Medicare ID - Type UnspecifiedRAILROAD MEDICARE
CA5034860001Medicare NSC