Provider Demographics
NPI:1013214527
Name:ELK GROVE URGENT CARE
Entity Type:Organization
Organization Name:ELK GROVE URGENT CARE
Other - Org Name:SACRAMENTO URGENT CARE INC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALLEN
Authorized Official - Middle Name:ICHIEH
Authorized Official - Last Name:LIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-422-9110
Mailing Address - Street 1:7200 S LAND PARK DR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3668
Mailing Address - Country:US
Mailing Address - Phone:916-422-9110
Mailing Address - Fax:916-226-2656
Practice Address - Street 1:7200 S LAND PARK DR
Practice Address - Street 2:SUITE 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3668
Practice Address - Country:US
Practice Address - Phone:916-422-9110
Practice Address - Fax:916-226-2656
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ELK GROVE URGENT CARE INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care