Provider Demographics
NPI:1346756988
Name:APOLLO PHYSICANS MEDICAL GROUP
Entity type:Organization
Organization Name:APOLLO PHYSICANS MEDICAL GROUP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAMANDEEP
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:DHALIWAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-281-5963
Mailing Address - Street 1:8191 TIMBERLAKE WAY STE 200
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95823-5419
Mailing Address - Country:US
Mailing Address - Phone:916-236-5800
Mailing Address - Fax:916-266-7473
Practice Address - Street 1:576 N SUNRISE AVE
Practice Address - Street 2:230A
Practice Address - City:ROSEVILLE
Practice Address - State:CA
Practice Address - Zip Code:95661-2841
Practice Address - Country:US
Practice Address - Phone:916-236-5800
Practice Address - Fax:916-244-4498
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-19
Last Update Date:2018-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA207Q00000X, 207R00000X
207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty