Provider Demographics
NPI:1528449949
Name:UC DAVIS MEDICAL CENTER
Entity type:Organization
Organization Name:UC DAVIS MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RESIDENT PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:KYLE
Authorized Official - Middle Name:
Authorized Official - Last Name:NATSUHARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:209-471-0937
Mailing Address - Street 1:8221 LAKE FOREST DR
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95826-2957
Mailing Address - Country:US
Mailing Address - Phone:209-969-7471
Mailing Address - Fax:
Practice Address - Street 1:4860 Y ST STE 3800
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95817-2307
Practice Address - Country:US
Practice Address - Phone:916-734-2011
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-11
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital