Sacramento Dermatology Med Group Inc

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

A24330 Issued in CA

Legal business name

SACRAMENTO DERMATOLOGY MED GROUP INC

Practice address

5525 Dewey Dr
#102
Fair Oaks, CA 95628-3129

Phone

(916) 966-9014

Fax

(916) 966-9015

NPI assigned

Nov 30, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Dennis Daughters, MD

Title

President

Phone

(916) 966-9014

Specialties & licenses 2

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1218153600000",
    "number": "1245308378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5525 DEWEY DR",
            "address_2": "#102",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283129",
            "telephone_number": "916-966-9014",
            "fax_number": "916-966-9015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5525 DEWEY DR",
            "address_2": "#102",
            "city": "FAIR OAKS",
            "state": "CA",
            "postal_code": "956283129",
            "telephone_number": "916-966-9014",
            "fax_number": "916-966-9015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SACRAMENTO DERMATOLOGY MED GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-30",
        "last_updated": "2008-08-08",
        "status": "A",
        "authorized_official_last_name": "DAUGHTERS",
        "authorized_official_first_name": "DENNIS",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-966-9014",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G22335",
            "primary": false
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dermatology",
            "state": "CA",
            "license": "A24330",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dermatology Physician in Fair Oaks, CA
• Providers in Fair Oaks, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.