Healthcare Provider Details

I. General information

NPI: 1134531049
Provider Name (Legal Business Name): WELL CARE CENTRAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/27/2014
Last Update Date: 08/22/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 COYLE AVE STE 3
CARMICHAEL CA
95608-6344
US

IV. Provider business mailing address

6600 COYLE AVE STE 3
CARMICHAEL CA
95608-6344
US

V. Phone/Fax

Practice location:
  • Phone: 916-436-4470
  • Fax: 916-965-1482
Mailing address:
  • Phone: 916-436-4470
  • Fax: 916-965-1482

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License NumberA70542
License Number StateCA

VIII. Authorized Official

Name: DR. RICHARD LYNTON
Title or Position: PRESIDENT/CEO
Credential: M.D., FACP
Phone: 916-436-4470