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General NPI Number Information
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NPI Number | 1477836245
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Entity Type | Organization
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Legal Business Name | RIPON PRIMARY & URGENT CARE CENTER A MEDICAL CORPORATION
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Dates
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Enumeration Date | 09/27/2011
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Last Update Date | 07/19/2012
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Provider Practice Location Address
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Address Line | 336 W MAIN ST
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City | RIPON
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State | CA
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Zip | 95366-2424
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Country | US
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Telephone | 209-599-5571
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Fax | 209-253-0701
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Provider Business Mailing Address
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Address Line | PO BOX 1170
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City | RIPON
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State | CA
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Zip | 95366-1170
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Country | US
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Telephone | 209-599-5571
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Fax | 209-253-0701
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Authorized Official
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Title or Position | CEO
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Name | MR. JAMES W. SIMMONS
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Credential | FNP
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Telephone | 209-482-6840
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number | FNP41647
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License Number State | CA
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