Provider Demographics
NPI:1003981226
Name:TOTAL CARE MEDICAL CENTER, INC.
Entity Type:Organization
Organization Name:TOTAL CARE MEDICAL CENTER, INC.
Other - Org Name:VALLEY CARE MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RENA
Authorized Official - Middle Name:
Authorized Official - Last Name:XIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-803-6797
Mailing Address - Street 1:2828 MILLS PARK DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-4711
Mailing Address - Country:US
Mailing Address - Phone:916-803-6797
Mailing Address - Fax:866-374-7518
Practice Address - Street 1:7248 S LAND PARK DR
Practice Address - Street 2:SUITE 105
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3660
Practice Address - Country:US
Practice Address - Phone:916-395-0826
Practice Address - Fax:916-395-8364
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA33249207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty