NPIMap

Organization Active NPI

Primary Care Family Medical Clinic Inc.

  • Primary Care Clinic/Center
  • Sacramento, CA
National Provider Identifier
1689628844
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
License
FNP34722 Issued in CA
Legal business name
PRIMARY CARE FAMILY MEDICAL CLINIC INC.
Practice address
7501 Hospital Dr
Suite 205
Sacramento, CA 95823-5405
Phone
(916) 689-2121
Fax
(916) 689-2198
NPI assigned
May 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Derrick John Mullin, FNPNPI 1366496911
Title
Manager
Phone
(916) 689-2121

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
Primary Care Clinic/Center 261QP2300X FNP34722 CA Primary

Addresses

Primary practice location

7501 Hospital Dr
Suite 205
Sacramento, CA 95823-5405

Mailing address

7501 Hospital Dr
Suite 205
Sacramento, CA 95823-5405
Phone (916) 689-2121

National Provider Directory

National Provider Directory

Locations

7501 Hospital Dr
Ste 205
Sacramento, CA 95823
Phone (916) 685-0395

Practitioners & affiliated clinicians

Practitioners 2

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": "1148083200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689628844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7501 HOSPITAL DR",
            "address_2": "SUITE 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235405",
            "telephone_number": "916-689-2121",
            "fax_number": "916-689-2198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7501 HOSPITAL DR",
            "address_2": "SUITE 205",
            "city": "SACRAMENTO",
            "state": "CA",
            "postal_code": "958235405",
            "telephone_number": "916-689-2121",
            "fax_number": "916-689-2198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE FAMILY MEDICAL CLINIC INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MULLIN",
        "authorized_official_first_name": "DERRICK",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "916-689-2121",
        "authorized_official_credential": "FNP"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": "CA",
            "license": "FNP34722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sacramento, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.