1407996093 NPI number — DR. MARCIA EHINGER M.D.

Table of content: DR. MARCIA EHINGER M.D. (NPI 1407996093)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407996093 NPI number — DR. MARCIA EHINGER M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EHINGER
Provider First Name:
MARCIA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
VALADEZ
Provider Other First Name:
MARCIA
Provider Other Middle Name:
EHINGER
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407996093
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6441 SANDSTONE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CARMICHAEL
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95608-0950
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-965-7536
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1515 K ST
Provider Second Line Business Practice Location Address:
SUITE 400, MS 8100
Provider Business Practice Location Address City Name:
SACRAMENTO
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95814-4051
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-327-3012
Provider Business Practice Location Address Fax Number:
916-327-1123
Provider Enumeration Date:
02/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207SG0201X , with the licence number:  G36354 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: G36354 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00G363540 , issued by the state of ( CA ) . This identifiers is of the category "MEDICAID".




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