| Sockolov & Sockolov A Professional Corporation | |
|
1 Scripps Dr 202 Sacramento CA 95825-6206 | |
| (916) 927-1114 | |
| (916) 927-3244 |
| Full Name | Sockolov & Sockolov A Professional Corporation |
|---|---|
| Speciality | Family Medicine |
| Location | 1 Scripps Dr, Sacramento, California |
| Authorized Official Name and Position | Ronald Sockolov (OWNER) |
| Authorized Official Contact | 9169271114 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sockolov & Sockolov A Professional Corporation 1 Scripps Dr 202 Sacramento CA 95825-6206 Ph: (916) 927-1114 | Sockolov & Sockolov A Professional Corporation 1 Scripps Dr 202 Sacramento CA 95825-6206 Ph: (916) 927-1114 |
| NPI Number | 1205875663 |
|---|---|
| Provider Enumeration Date | 06/04/2006 |
| Last Update Date | 01/07/2014 |
| Medicare PECOS PAC ID | 4284732348 |
|---|---|
| Medicare Enrollment ID | O20070613000413 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1205875663 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Lisa Anne Swensson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1235268251 PECOS PAC ID: 9830163286 Enrollment ID: I20040823000668 |
| Provider Name | Jude T Waterbury |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1487626594 PECOS PAC ID: 2062468366 Enrollment ID: I20051103001052 |
| Provider Name | Eddy Joelson |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1043294580 PECOS PAC ID: 2163435181 Enrollment ID: I20060717000117 |
| Provider Name | Ronald Sockolov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871531699 PECOS PAC ID: 7012008394 Enrollment ID: I20070801000714 |
| Provider Name | Alvin M Sockolov |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1821043753 PECOS PAC ID: 0840381125 Enrollment ID: I20070801000750 |
| Provider Name | Ingvild G Lane |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1831171719 PECOS PAC ID: 5294817573 Enrollment ID: I20080124000720 |
| Provider Name | Leah N Grossman |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891081311 PECOS PAC ID: 1254584014 Enrollment ID: I20130104000180 |
| Provider Name | Samantha A Gove |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861948952 PECOS PAC ID: 1052692704 Enrollment ID: I20170111002824 |
| Provider Name | Rex T Chan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1821583576 PECOS PAC ID: 4082950613 Enrollment ID: I20190117003380 |
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