Healthcare Provider Details
I. General information
NPI: 1225966880
Provider Name (Legal Business Name): PRIMEMD CLINICS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5800 STANFORD RANCH RD SUITE 720
ROCKLIN CA
95765
US
IV. Provider business mailing address
2108 N ST STE N
SACRAMENTO CA
95816-5712
US
V. Phone/Fax
- Phone: 916-235-3935
- Fax: 703-977-2063
- Phone: 916-235-3935
- Fax: 703-977-2063
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SURESH
K
PASYA
Title or Position: PHYSICIAN
Credential: MD
Phone: 916-235-3935