LT Proactive Care Clinic California, PA

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

LT PROACTIVE CARE CLINIC CALIFORNIA, PA

Doing business as

LT Proactive Care Clinic

Practice address

1435 East Roseville Pkwy
Roseville, CA 95661

Phone

(916) 472-2057

Fax

(916) 472-2058

NPI assigned

Sep 25, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Kambiz Farbakhsh, M.D.

Title

Owner/Medical Director

Phone

(952) 541-7157

Specialties & licenses 2

Addresses

Other names 1

• LT Proactive Care Clinic Doing business as

Locations

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

{
    "created_epoch": "1443139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443139200000",
    "number": "1801266499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1435 EAST ROSEVILLE PKWY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-472-2057",
            "fax_number": "916-472-2058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1435 EAST ROSEVILLE PKWY",
            "city": "ROSEVILLE",
            "state": "CA",
            "postal_code": "95661",
            "telephone_number": "916-472-2057",
            "fax_number": "916-472-2058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LT PROACTIVE CARE CLINIC CALIFORNIA, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-25",
        "last_updated": "2015-09-25",
        "status": "A",
        "authorized_official_last_name": "FARBAKHSH",
        "authorized_official_first_name": "KAMBIZ",
        "authorized_official_title_or_position": "OWNER/MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "952-541-7157",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LT Proactive Care Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Jame Lowe, PA
• Jacob Lowery
• Laura M Lowry, PSY.D.
• Tatiana Loza -Hine, SLP
• LS Transit Inc
• Yih Jen Lu, DPT
• Madeline Lubrico, RD
• Julia Lucas, PH.D.
• Gilbert R Luceno, MD
• Cara Ann Lucero, L.C.S.W.

• Primary Care Clinic/Center in Roseville, CA
• Providers in Roseville, CA by specialty
• Primary Care Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2015; 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.