MEDICARE: TOTAL CARE MEDICAL CENTER, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A33249	CA

General Provider Information

NPI Number	:	1003981226
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOTAL CARE MEDICAL CENTER, INC.

Provider Business Mailing Address
First Line	:	2828 MILLS PARK DR
Second Line	:	SUITE E
City	:	RANCHO CORDOVA
State	:	CA
Zip	:	95670-4711
Country	:	US
Telephone Number	:	916-803-6797
Fax Number	:	866-374-7518

Provider Business Practice Location Address
First Line	:	7248 S LAND PARK DR
Second Line	:	SUITE 105
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3660
Country	:	US
Telephone Number	:	916-395-0826
Fax Number	:	916-395-8364

Authorized Official
Title or Position	:	PRESIDENT
Name	:	RENA XIAN
Credential	:
Telephone Number	:	916-803-6797

Provider Enumeration Date	:	11/22/2006
Last Update Date	:	08/22/2020

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