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LT PROACTIVE CARE CLINIC CALIFORNIA PA NPI 1801266499


NPI Information

NPI: 1801266499
Provider Name: LT PROACTIVE CARE CLINIC CALIFORNIA, PA

Doing Business As: LT PROACTIVE CARE CLINIC

Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

Address:
1435 EAST ROSEVILLE PKWY
ROSEVILLE, CA
ZIP 95661
Phone: (916) 472-2057
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LT PROACTIVE CARE CLINIC CALIFORNIA, PA is a primary care clinic center in Roseville, CA. LT PROACTIVE CARE CLINIC CALIFORNIA, PA NPI is 1801266499. The provider is registered as an organization entity type.
The provider Is Doing Business As Lt Proactive Care Clinic.

The provider's business location address is:

1435 EAST ROSEVILLE PKWY
ROSEVILLE, CA
ZIP 95661
Phone: (916) 472-2057
Fax: (916) 472-2058

The provider's authorized official is Kambiz Farbakhsh .
The authorized official title is Owner/medical Director and has the following contact phone number (952) 541-7157.

The enumeration date for this NPI number is 9/25/2015 and was last updated on 9/25/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1261QH0100XClinic/CenterHealth ServiceNo
2261QP2300XClinic/CenterPrimary CareYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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