Active NPI
Eyobe Mamo
- Private Vehicle
- Sacramento, CA
National Provider Identifier
1295510840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Private Vehicle
- License
- 6ZIA942
- Practice address
- 4501 Auburn Blvd
Suite 106a
Sacramento, CA 95841 - Phone
- (279) 842-7288
- NPI assigned
- Aug 30, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Non-emergency Medical Transport (VAN) | 343900000X | |||
| Private Vehicle | 347C00000X | 6ZIA942 | CA | Primary |
Addresses
Primary practice location
4501 Auburn Blvd
Suite 106a
Sacramento, CA 95841
Mailing address
4501 Auburn Blvd
Suite 106a
Sacramento, CA 95841
Phone (916) 549-5639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6ZIA942 | CA | MD | Private Vehicle |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1693353600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1693353600000",
"number": "1295510840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4501 AUBURN BLVD",
"address_2": "SUITE 106A",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95841",
"telephone_number": "916-549-5639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4501 AUBURN BLVD",
"address_2": "SUITE 106A",
"city": "SACRAMENTO",
"state": "CA",
"postal_code": "95841",
"telephone_number": "279-842-7288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAMO",
"first_name": "EYOBE",
"name_prefix": "Mr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-08-30",
"last_updated": "2023-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "343900000X",
"taxonomy_group": "",
"desc": "Non-emergency Medical Transport (VAN)",
"state": null,
"license": null,
"primary": false
},
{
"code": "347C00000X",
"taxonomy_group": "",
"desc": "Private Vehicle",
"state": "CA",
"license": "6ZIA942",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sacramento, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.