5 Rivers Health Inc
Organization Active NPI Internal Medicine Physician · Rocklin, CA
NPI 1497592869 · NPPES record last updated Jul 11, 2024
Key facts
- NPI
- 1497592869
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- 5 RIVERS HEALTH INC
- Practice address
- 6839 Five Star Blvd Ste C
Rocklin, CA 95677-2685 - Phone
- (916) 742-7103
- Fax
- (916) 742-7102
- NPI assigned
- Jul 11, 2024
- Organization subpart
- No
Authorized official
- Name
- Rajmeet Kaur Mann
- Title
- MD
- Phone
- (916) 742-7103
Practitioners 9
-
Zarlasht Fakiri, D.O
-
Nataliya Dorofeyev, PA-C
-
Ramneek Kaur Kahlon, NURSE PRACTITIONER
-
Dong Hyun John Kim, D.O.
-
Lashunda Phillips, RN, FNP-C
-
Swaiman Singh, M.D.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 05D2314050 | 5 Rivers Health, Inc | Certificate of waiver | Nov 11, 2026 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250128001316 | CA | Part B Supplier - Clinic/Group Practice | 6800325499 |
Receives reassigned benefits from 7 practitioners Practice locations: Rocklin, CA |
National Provider Directory
Locations
6839 Five Star Blvd
Ste C
Rocklin, CA 95677
Phone (916) 742-7103
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician |
207R00000X | Yes |
Addresses
Primary practice location
6839 Five Star Blvd Ste C
Rocklin, CA 95677-2685
Mailing address
6839 Five Star Blvd Ste C
Rocklin, CA 95677-2685
Phone (916) 742-7103
Other providers in Rocklin, CA
All providers in Rocklin, CA · Internal Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 11, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.