Provider Demographics
NPI:1396198958
Name:RIVER CITY MEDICAL GROUP INC
Entity Type:Organization
Organization Name:RIVER CITY MEDICAL GROUP INC
Other - Org Name:SACRAMENTO FAMILY MEDICAL CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CREDENTIALING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AMY
Authorized Official - Middle Name:
Authorized Official - Last Name:CLOTHIER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:916-228-4300
Mailing Address - Street 1:7311 GREENHAVEN DR STE 145
Mailing Address - Street 2:
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3595
Mailing Address - Country:US
Mailing Address - Phone:916-228-4300
Mailing Address - Fax:
Practice Address - Street 1:7311 GREENHAVEN DR
Practice Address - Street 2:SUITE 145
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3572
Practice Address - Country:US
Practice Address - Phone:916-228-4300
Practice Address - Fax:916-424-6200
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:RIVER CITY MEDICAL GROUP INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2016-07-19
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty