Healthcare Provider Details

I. General information

NPI: 1700755238
Provider Name (Legal Business Name): HENDRICKS MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/03/2025
Last Update Date: 11/05/2025
Certification Date: 11/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2510 DOUGLAS BLVD STE 200
ROSEVILLE CA
95661-3301
US

IV. Provider business mailing address

3240 PROFESSIONAL DR
AUBURN CA
95602-2409
US

V. Phone/Fax

Practice location:
  • Phone: 530-217-5868
  • Fax:
Mailing address:
  • Phone: 530-217-5868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207ZC0006X
TaxonomyClinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: AUSTIN FLOHR
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 530-217-5868