Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | G79283 | CA |
NPI | 1295844074 |
---|---|
Provider Name | Anthony Francis Bellomo |
First Address | Sacramento, CA 95816-4307 |
Second Address | Sacramento, CA 95816-4307 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/08/2006 |
Last Update Date | 26/02/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G792830 | BLUE SHIELD (01) | CA |
F92808 | (02) | CA |
P00000560 | RAILROAD MEDICARE (01) | CA |