Provider Demographics
NPI:1144414293
Name:HEALTHY LIVING PRIMARY CARE, INC
Entity Type:Organization
Organization Name:HEALTHY LIVING PRIMARY CARE, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:
Authorized Official - Last Name:LIU
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:916-983-8868
Mailing Address - Street 1:2545 E BIDWELL ST
Mailing Address - Street 2:110
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-6440
Mailing Address - Country:US
Mailing Address - Phone:916-983-9886
Mailing Address - Fax:916-983-8891
Practice Address - Street 1:82 CLARKSVILLE RD STE 120
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8210
Practice Address - Country:US
Practice Address - Phone:916-983-8868
Practice Address - Fax:916-983-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9350207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty