Provider Demographics
NPI:1780671693
Name:RAPIDCARE WALK IN MEDICAL GROUP, INC.
Entity Type:Organization
Organization Name:RAPIDCARE WALK IN MEDICAL GROUP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ARA
Authorized Official - Middle Name:
Authorized Official - Last Name:TAVITIAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-673-1200
Mailing Address - Street 1:13385 FOLSOM BLVD
Mailing Address - Street 2:#800
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-8322
Mailing Address - Country:US
Mailing Address - Phone:916-673-1200
Mailing Address - Fax:916-673-1201
Practice Address - Street 1:13385 FOLSOM BLVD
Practice Address - Street 2:#800
Practice Address - City:FOLSOM
Practice Address - State:CA
Practice Address - Zip Code:95630-8322
Practice Address - Country:US
Practice Address - Phone:916-673-1200
Practice Address - Fax:916-673-1201
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAZZZ28279Z261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0064420Medicaid
CAZZZ28279ZMedicare ID - Type Unspecified