BOOMER MEDICAL CLINIC – NPI #1538458351
Physical Medicine & Rehabilitation

A physician who addresses the prevention, diagnosis, treatment and management of traumatic spinal cord injury and non-traumatic etiologies of spinal cord dysfunction by working in an interdisciplinary manner. Care is provided to patients of all ages on a lifelong basis and covers related medical, physical, psychological and vocational disabilities and complications.

Health Care Provider Taxonomy Code for Physical Medicine & Rehabilitation

BOOMER MEDICAL CLINIC is a provider located in SACRAMENTO, CA. NPPES has assigned the NPI number 1538458351 to BOOMER MEDICAL CLINIC on April 01, 2011. It is a Type-2 NPI, indicating this NPI number is associated with an organization. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 2081P0004X from the Health Care Provider Taxonomy code set, which is classified as Physical Medicine & Rehabilitation, specializing in Spinal Cord Injury Medicine

The NPI profile was previously updated about 14 years ago on Feb 20, 2012. 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 BOOMER MEDICAL CLINIC below.

NPI Profile for
BOOMER MEDICAL CLINIC

NPI Number
1538458351
Enumeration Date

(more than 15 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
BOOMER MEDICAL CLINIC
Primary location
3525 WATT AVE
SACRAMENTO, CA 95821
Phone: (916) 480-0707 Fax:
Mailing address
PO BOX 1939
CARMICHAEL, CA 95609-1939
Phone: Fax:
Organization Subpart
No
Authorized Official
KIMBERLY LE
MEDICAL DIRECTOR
Phone: (916) 480-0707
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
2081P0004X
- Physical Medicine & Rehabilitation / Spinal Cord Injury Medicine (Primary)		 CA G72879
207P00000X
- Emergency Medicine		 CA A46083

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.