Provider Demographics
NPI:1487064952
Name:RANCHO CORDOVA MEDICAL CLINIC AND URGENT CARE
Entity type:Organization
Organization Name:RANCHO CORDOVA MEDICAL CLINIC AND URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SULTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:YUSUFZAI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-704-5898
Mailing Address - Street 1:2890 LA LOMA DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-3308
Mailing Address - Country:US
Mailing Address - Phone:916-376-7069
Mailing Address - Fax:
Practice Address - Street 1:2890 LA LOMA DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-3308
Practice Address - Country:US
Practice Address - Phone:916-704-5898
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-05
Last Update Date:2015-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA127254207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty