Organization Active NPI

Mediwell, Inc.

  • Primary Care Clinic/Center
  • Folsom, CA
National Provider Identifier
1598845562
Registry record updated Sep 8, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
A055920 Issued in CA
Legal business name
MEDIWELL, INC.
Practice address
1733 Creekside Dr
Folsom, CA 95630-3457
Phone
(916) 458-9355
Fax
(916) 458-9353
NPI assigned
Oct 16, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 8, 2008

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

Authorized official

Name
Mr. Ravdeep Singh Bhasin
Title
Ceo
Phone
(916) 458-9355

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X A055920 CA Primary

Addresses

Primary practice location

1733 Creekside Dr
Folsom, CA 95630-3457

Mailing address

1733 Creekside Dr
Folsom, CA 95630-3457
Phone (916) 458-9355

Other identifiers 2

IdentifierTypeStateIssuer
ZZZ28024ZOtherCAMEDICARE GROUP NUMBER
GR0095610MedicaidCA

Other names 1

  • Mediwell Medical Group Doing business as

National Provider Directory

National Provider Directory

Locations

1733 Creekside Dr
Folsom, CA 95630
Phone (916) 458-9355

2939 Mather Field Rd
#2
Rncho Cordova, CA 95670
Phone (916) 363-3039

Practitioners & affiliated clinicians

Practitioners 3

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": "1160956800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220832000000",
    "number": "1598845562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1733 CREEKSIDE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303457",
            "telephone_number": "916-458-9355",
            "fax_number": "916-458-9353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1733 CREEKSIDE DR",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956303457",
            "telephone_number": "916-458-9355",
            "fax_number": "916-458-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDIWELL, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-16",
        "last_updated": "2008-09-08",
        "status": "A",
        "authorized_official_last_name": "BHASIN",
        "authorized_official_first_name": "RAVDEEP",
        "authorized_official_middle_name": "SINGH",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "916-458-9355",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "A055920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP NUMBER",
            "identifier": "ZZZ28024Z",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GR0095610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mediwell Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Sep 8, 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.