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Contact Information

CAPITOL CITY MEDICAL GROUP, INC
500 UNIVERSITY AVE
SUITE 200
SACRAMENTO, CA95825-6523
 Phone: 916-920-1200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Bone Densitometry Radiologic Technologist

2471B0102X
 

Primary Care

261QP2300X
Indicates primary specialty

NPI Profile & details for CAPITOL CITY MEDICAL GROUP, INC

NPI Number 1447238092
LBN Legal business name CAPITOL CITY MEDICAL GROUP, INC
Authorized official ROSE ULLERY - (ADMINISTRATOR)
Entity Organization
Organization subpart 1 No
Enumeration date 01/04/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
CA Medicaid GR0088950
CA Other ZZZ61216Z BLUE SHIELD PROVIDER ID
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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