Provider Demographics
NPI:1346838240
Name:FOLSOM TOTAL JOINT CENTER, LLC
Entity Type:Organization
Organization Name:FOLSOM TOTAL JOINT CENTER, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:SIMONE
Authorized Official - Middle Name:RENATE
Authorized Official - Last Name:MUELLER
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:805-766-6319
Mailing Address - Street 1:136 W BRANCH ST
Mailing Address - Street 2:
Mailing Address - City:ARROYO GRANDE
Mailing Address - State:CA
Mailing Address - Zip Code:93420-2602
Mailing Address - Country:US
Mailing Address - Phone:805-766-6319
Mailing Address - Fax:
Practice Address - Street 1:530 PLAZA DR STE 110
Practice Address - Street 2:
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-4782
Practice Address - Country:US
Practice Address - Phone:805-766-6319
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-06
Last Update Date:2023-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty