NPIMap

Organization Active NPI

Rancho Cordova Medical Clinic and Urgent Care

  • Internal Medicine Physician
  • Rancho Cordova, CA
National Provider Identifier
1487064952
Registry record updated Sep 2, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
A127254 Issued in CA
Legal business name
RANCHO CORDOVA MEDICAL CLINIC AND URGENT CARE
Practice address
2890 La Loma Dr
Rancho Cordova, CA 95670-3308
Phone
(916) 704-5898
NPI assigned
May 5, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Sultan Yusufzai, MDNPI 1831479815
Title
Physician / Owner
Phone
(916) 704-5898

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207R00000X A127254 CA Primary

Addresses

Primary practice location

2890 La Loma Dr
Rancho Cordova, CA 95670-3308

Mailing address

2890 La Loma Dr
Rancho Cordova, CA 95670-3308
Phone (916) 376-7069

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20151116000146 CA Part B Supplier - Clinic/Group Practice 1658681010 Receives reassigned benefits from 5 practitioners
Practice locations: Sacramento, CA; Auburn, CA

National Provider Directory

National Provider Directory

Locations

3237 Professional Dr
Auburn, CA 95602
Phone (530) 885-8128

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441152000000",
    "number": "1487064952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2890 LA LOMA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956703308",
            "telephone_number": "916-376-7069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2890 LA LOMA DR",
            "city": "RANCHO CORDOVA",
            "state": "CA",
            "postal_code": "956703308",
            "telephone_number": "916-704-5898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RANCHO CORDOVA MEDICAL CLINIC AND URGENT CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-05",
        "last_updated": "2015-09-02",
        "status": "A",
        "authorized_official_last_name": "YUSUFZAI",
        "authorized_official_first_name": "SULTAN",
        "authorized_official_title_or_position": "PHYSICIAN / OWNER",
        "authorized_official_telephone_number": "916-704-5898",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A127254",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rancho Cordova, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.