| Ppm California Llc | |
|
6929 Sunrise Blvd Ste 180 Citrus Heights CA 95610-3164 | |
| (888) 253-6598 | |
| Not Available |
| Full Name | Ppm California Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 6929 Sunrise Blvd Ste 180, Citrus Heights, California |
| Authorized Official Name and Position | Lee Johnson (TREASURER) |
| Authorized Official Contact | 2084011369 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ppm California Llc 1916 N 700 W Ste 110 Layton UT 84041-5754 Ph: (888) 253-6598 | Ppm California Llc 6929 Sunrise Blvd Ste 180 Citrus Heights CA 95610-3164 Ph: (888) 253-6598 |
| NPI Number | 1578261749 |
|---|---|
| Provider Enumeration Date | 02/17/2023 |
| Last Update Date | 02/17/2023 |
| Medicare PECOS PAC ID | 0749655538 |
|---|---|
| Medicare Enrollment ID | O20230410000567 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578261749 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Galen H Church |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1467487868 PECOS PAC ID: 5092793109 Enrollment ID: I20040713001169 |
| Provider Name | Christi Barnas |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1700297801 PECOS PAC ID: 0840589248 Enrollment ID: I20180109001358 |
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