Provider Demographics
NPI:1316380652
Name:PACE EXTENDED CARE INC.
Entity Type:Organization
Organization Name:PACE EXTENDED CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR.
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:A
Authorized Official - Last Name:ZAIDI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-745-2381
Mailing Address - Street 1:PO BOX 2074
Mailing Address - Street 2:
Mailing Address - City:GRANITE BAY
Mailing Address - State:CA
Mailing Address - Zip Code:95746
Mailing Address - Country:US
Mailing Address - Phone:916-745-2381
Mailing Address - Fax:
Practice Address - Street 1:5255 HEMLOCK ST
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95841-3017
Practice Address - Country:US
Practice Address - Phone:916-745-2381
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-16
Last Update Date:2013-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA107500207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty