Physician Referral Information
Required Information
Please fax the following information to 916-734-6034.
- PT Records/Pathology
- CD of CT, MRI, and/or PET Scans (required for appointment)
- PT Demographic Information
- PT Insurance Information (Subscriber Info, ID #, Customer Service Plan)
- Authorization for CPT Code 99245, PT will not be scheduled without authorization
- Referring MD Information
- Referral Coordinator Contact Information with Direct/Back Line Phone Number
In addition, please mail Pathology Slides to Alicia Martinez at UC Davis Medical Center
4860 Y Street, Suite 2500
Sacramento, CA 95817
Contact Information:
UC Davis Comprehensive Cancer Center
Gynecologic Oncology
New Patient Referrals
2279 45th Street
Sacramento, CA 95817
Phone: (916) 736-6958
Fax: (916) 703-5266