Organization · NPI-2

Alpha Omega Iom A Medical Corporation

Orthopaedic Surgery, Orthopaedic Surgery of the Spine · Roseville, CA

NPI number1801531090

StatusActive

Last updated in NPPESMay 2, 2022

Details

NPI: 1801531090
Entity type: Organization (NPI-2)
Legal business name: Alpha Omega Iom A Medical Corporation
Organization subpart: No
Enumeration date: May 2, 2022
Certification date: May 2, 2022
Last updated: May 2, 2022

Taxonomy and licenses

Taxonomy code	Description	License	State	Primary
207XS0117X	Orthopaedic Surgery, Orthopaedic Surgery of the Spine	–	–	Yes
2084N0400X	Psychiatry & Neurology, Neurology	–	–
231H00000X	Audiologist	–	–
2355A2700X	Specialist/Technologist, Audiology Assistant	–	–

Practice location

5 Medical Plaza Dr Ste 120b
Roseville, CA 95661-2866

Phone 916-352-0016

Mailing address

5 Medical Plaza Dr Ste 120b
Roseville, CA 95661-2866

Phone 916-352-0016

Authorized official

Tyler Smith
Owner
9163520016

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