Folsom Obstetrics & Gynecology Medical Group Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

G51481 Issued in CA

Legal business name

FOLSOM OBSTETRICS & GYNECOLOGY MEDICAL GROUP INC

Doing business as

Folsom Obstetrics and Gynecology Medical Group Inc

Practice address

1735 Creekside Dr
Folsom, CA 95630-3457

Phone

(916) 983-3500

Fax

(916) 983-8437

NPI assigned

Mar 21, 2007

Last updated

Dec 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Richard Cragun, M.D.

Title

Owner President

Phone

(916) 983-3500

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• FOLSOM OBSTETRICS AND GYNECOLOGY MEDICAL GROUP INC Doing business as

Locations

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

{
    "created_epoch": "1174435200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1451260800000",
    "number": "1285750505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9474 SWAN LAKE DR",
            "city": "GRANITE BAY",
            "state": "CA",
            "postal_code": "957467205",
            "telephone_number": "916-797-6004",
            "fax_number": "916-797-6004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1735 CREEKSIDE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303457",
            "telephone_number": "916-983-3500",
            "fax_number": "916-983-8437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOLSOM OBSTETRICS & GYNECOLOGY MEDICAL GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-21",
        "last_updated": "2015-12-28",
        "status": "A",
        "authorized_official_last_name": "CRAGUN",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "916-983-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "CA",
            "license": "G51481",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "ZZZ18311Z",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FOLSOM OBSTETRICS AND GYNECOLOGY MEDICAL GROUP INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Specialist in Folsom, CA
• Providers in Folsom, CA by specialty
• Specialist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2015; 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.