Active NPI
Mediwell, Inc.
- Primary Care Clinic/Center
- Folsom, CA
National Provider Identifier
1598845562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Primary Care Clinic/Center
- License
- A055920
- 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
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| ZZZ28024Z | Other | CA | MEDICARE GROUP NUMBER |
| GR0095610 | Medicaid | CA |
Other names 1
- Mediwell Medical Group
National Provider Directory
National Provider DirectoryLocations
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.
-
- Chiropractor
- Placerville, CA
- NPI 1770693111
-
- Chiropractor
- Orangevale, CA
- NPI 1487874657
-
- Family Medicine Physician
- Rancho Cordova, CA
- NPI 1689605602
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.