1720786734 NPI number — CAPITAL INTEGRATIVE RHEUMATOLOGY INC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720786734 NPI number — CAPITAL INTEGRATIVE RHEUMATOLOGY INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CAPITAL INTEGRATIVE RHEUMATOLOGY INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1720786734
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/23/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 2999
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GRANITE BAY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95746-2999
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-292-9006
Provider Business Mailing Address Fax Number:
531-200-7513

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2150 E BIDWELL ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOLSOM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95630-6453
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-567-3500
Provider Business Practice Location Address Fax Number:
844-722-9257
Provider Enumeration Date:
02/20/2023

Additional Information

Authorized Official

Authorized Official Last Name:
SANDHU
Authorized Official First Name:
HARBRINDER
Authorized Official Middle Name:
S
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
518-320-6964

Provider Taxonomy Codes

  • Taxonomy code: 207RR0500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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