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General NPI Number Information
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NPI Number | 1538300686
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Entity Type | Organization
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Legal Business Name | RIVER CITY MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 03/19/2009
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Last Update Date | 01/02/2026
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Provider Practice Location Address
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Address Line | 7311 GREENHAVEN DRIVE SUITE 145
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City | SACRAMENTO
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State | CA
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Zip | 95831-3589
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Country | US
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Telephone | 916-228-4300
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Fax | 916-424-6200
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Provider Business Mailing Address
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Address Line | 7311 GREENHAVEN DR STE 145
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City | SACRAMENTO
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State | CA
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Zip | 95831-3595
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Country | US
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Telephone | 916-228-4300
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING MANAGER
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Name | MISS AMY CLOTHIER
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Credential |
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Telephone | 916-228-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251X00000X
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Taxonomy Name | Supports Brokerage Agency
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 171W00000X
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Taxonomy Name | Contractor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 302F00000X
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Taxonomy Name | Exclusive Provider Organization
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License Number | 302F00000X
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License Number State | CA
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