CALIFORNIA MATERNAL FETAL MEDICINE INC
Complete NPI Record 1386286979
Obstetrics & Gynecology - Maternal & Fetal Medicine in Sacramento, CA

NPI Status: Active since October 15, 2019

Contact Information

100 HOWE AVE STE 186N
SACRAMENTO, CA
ZIP 95825
Phone: (916) 603-5600
Fax: (855) 815-4684

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Complete NPI Dataset

This page represents the complete record for NPI 1386286979. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1386286979
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
Entity Type Code: 2
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Employer Identification Number EIN: UNAVAIL
The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
The name of the organization provider. If the provider is an organization, this is the legal business name.
Provider First Line Business Mailing Address: 1645 CREEKSIDE DR
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: FOLSOM
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: CA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 956303832
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 9166035600
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider First Line Business Practice Location Address: 100 HOWE AVE STE 186N
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City Name: SACRAMENTO
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State Name: CA
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 958258219
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The country code in the location address of the provider being identified.
Provider Business Practice Location Address Telephone Number: 9166035600
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8558154684
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 10/15/2019
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 8/21/2024
The date that a record was last updated or changed.
Authorized Official Last Name: ALLEN
The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
Authorized Official First Name: DIANA
The first name of the authorized official.
Authorized Official Title or Position: EXECUTIVE DIRECTOR
The title or position of the authorized official.
Authorized Official Telephone Number: 9166035600
The 10-position telephone number of the authorized official.
Healthcare Provider Taxonomy Code 1: 207VM0101X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: 1386286979
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 01
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: CA
Other Provider Identifier Issuer 1: NPI
Is Organization Subpart: N
Healthcare Provider Taxonomy Group 1: 193400000X SINGLE SPECIALTY GROUP
NPI Certification Date: 8/21/2024