Provider Demographics
NPI:1861813362
Name:RESTPADD HEALTH CORP
Entity Type:Organization
Organization Name:RESTPADD HEALTH CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:O
Authorized Official - Middle Name:
Authorized Official - Last Name:NWANGBURUKA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-405-6010
Mailing Address - Street 1:PO BOX 581086
Mailing Address - Street 2:
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-0019
Mailing Address - Country:US
Mailing Address - Phone:916-405-6010
Mailing Address - Fax:916-405-6090
Practice Address - Street 1:7551 TIMBERLAKE WAY
Practice Address - Street 2:
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95823-5420
Practice Address - Country:US
Practice Address - Phone:916-405-6010
Practice Address - Fax:916-405-6090
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-30
Last Update Date:2013-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC3621827261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service