LT PROACTIVE CARE CLINIC – NPI #1801266499
Clinic/Center

LT PROACTIVE CARE CLINIC is an AHC clinic located in ROSEVILLE, CA. NPPES has assigned the NPI number 1801266499 to LT PROACTIVE CARE CLINIC on September 25, 2015. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “LT PROACTIVE CARE CLINIC” is a dba name, the actual legal business name for this organization is LT PROACTIVE CARE CLINIC CALIFORNIA, PA. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QP2300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Primary Care

Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LT PROACTIVE CARE CLINIC below.

NPI Profile for
LT PROACTIVE CARE CLINIC CALIFORNIA, PA

NPI Number
1801266499
Enumeration Date

(more than 10 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LT PROACTIVE CARE CLINIC CALIFORNIA, PA
Doing Business As (dba): LT PROACTIVE CARE CLINIC
Primary location
1435 EAST ROSEVILLE PKWY
ROSEVILLE, CA 95661
Phone: (916) 472-2057 Fax: (916) 472-2058
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
KAMBIZ FARBAKHSH
OWNER/MEDICAL DIRECTOR
Phone: (952) 541-7157
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QP2300X
- Clinic/Center / Primary Care (Primary)
261QH0100X
- Clinic/Center / Health Service

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.