| Folsom Lake Primary Care Pc | |
|
2575 E Bidwell St Ste 210 Folsom CA 95630-6446 | |
| (916) 984-7850 | |
| Not Available |
| Full Name | Folsom Lake Primary Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2575 E Bidwell St Ste 210, Folsom, California |
| Authorized Official Name and Position | Hadi Firoz (PRESIDENT) |
| Authorized Official Contact | 9167900450 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Folsom Lake Primary Care Pc 271 American River Canyon Dr Folsom CA 95630-7143 Ph: () - | Folsom Lake Primary Care Pc 2575 E Bidwell St Ste 210 Folsom CA 95630-6446 Ph: (916) 984-7850 |
| NPI Number | 1043705718 |
|---|---|
| Provider Enumeration Date | 06/26/2018 |
| Last Update Date | 06/26/2018 |
| Medicare PECOS PAC ID | 4385992940 |
|---|---|
| Medicare Enrollment ID | O20180730003405 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043705718 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | C56218 (California) | Primary |
| Provider Name | Hadi Firoz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1972576270 PECOS PAC ID: 7719884816 Enrollment ID: I20140314000137 |
| Provider Name | Jasleen Kaur Agroia |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1457069296 PECOS PAC ID: 3173986874 Enrollment ID: I20230829001115 |
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