| Timberlake Family Practice, A Medical Corp. | |
|
9381 E Stockton Blvd Ste 216 Elk Grove CA 95624-5070 | |
| (916) 691-5855 | |
| (916) 691-6066 |
| Full Name | Timberlake Family Practice, A Medical Corp. |
|---|---|
| Speciality | Family Medicine |
| Location | 9381 E Stockton Blvd Ste 216, Elk Grove, California |
| Authorized Official Name and Position | Joe Le (PHYSICIAN) |
| Authorized Official Contact | 9166915855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Timberlake Family Practice, A Medical Corp. 9381 E Stockton Blvd Ste 216 Elk Grove CA 95624-5070 Ph: (916) 691-5855 | Timberlake Family Practice, A Medical Corp. 9381 E Stockton Blvd Ste 216 Elk Grove CA 95624-5070 Ph: (916) 691-5855 |
| NPI Number | 1962516591 |
|---|---|
| Provider Enumeration Date | 08/19/2006 |
| Last Update Date | 02/01/2019 |
| Medicare PECOS PAC ID | 7214931104 |
|---|---|
| Medicare Enrollment ID | O20060907000307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962516591 | NPI | - | NPPES |
| 222025702 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Joe Le |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1154345536 PECOS PAC ID: 4082601828 Enrollment ID: I20040426001219 |
| Provider Name | Luz M Alcaraz |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1295793552 PECOS PAC ID: 0345238283 Enrollment ID: I20040430001396 |
| Provider Name | Reed Huy Vuong |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295715126 PECOS PAC ID: 3375582737 Enrollment ID: I20050426001070 |
| Provider Name | Wendy S Chase |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1801875398 PECOS PAC ID: 1254439128 Enrollment ID: I20070531000539 |
| Provider Name | Dolores A Calderon |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1417989666 PECOS PAC ID: 3072647213 Enrollment ID: I20120327000199 |
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