NPIMap

Organization Active NPI

Creekside Osteopathic Family Practice Inc

  • Family Medicine Physician
  • Folsom, CA
National Provider Identifier
1558395509
Registry record updated Jul 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
20A5262 Issued in CA
Legal business name
CREEKSIDE OSTEOPATHIC FAMILY PRACTICE INC
Practice address
1731 Creekside Dr
#100
Folsom, CA 95630
Phone
(916) 984-4100
Fax
(916) 984-4154
NPI assigned
Jul 10, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2008

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

Authorized official

Name
Dr. Randall M West, DONPI 1518957562
Title
President
Phone
(916) 984-4100

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
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 20A5262 CA Primary

Addresses

Primary practice location

1731 Creekside Dr
#100
Folsom, CA 95630

Mailing address

1731 Creekside Dr
#100
Folsom, CA 95630
Phone (916) 984-4100

National Provider Directory

National Provider Directory

Locations

1731 Creekside Dr
Ste 100
Folsom, CA 95630
Phone (916) 984-4100

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215648000000",
    "number": "1558395509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1731 CREEKSIDE DR",
            "address_2": "#100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-984-4100",
            "fax_number": "916-984-4154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1731 CREEKSIDE DR",
            "address_2": "#100",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "95630",
            "telephone_number": "916-984-4100",
            "fax_number": "916-984-4154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CREEKSIDE OSTEOPATHIC FAMILY PRACTICE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-10",
        "last_updated": "2008-07-10",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "916-984-4100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "20A5262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.