MEDICARE: ALSHIFA MEDICAL GROUP

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1336472240
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALSHIFA MEDICAL GROUP

Provider Business Mailing Address
First Line	:	3605 AGNETA COURT
Second Line	:	C/O MARGARET KAPASI
City	:	ELK GROVE
State	:	CA
Zip	:	95758-7408
Country	:	US
Telephone Number	:	916-501-0728
Fax Number	:	916-683-9604

Provider Business Practice Location Address
First Line	:	8325 ELK GROVE FLORIN RD
Second Line	:	SUITE 800
City	:	SACRAMENTO
State	:	CA
Zip	:	95829-9523
Country	:	US
Telephone Number	:	916-226-6190
Fax Number	:	916-689-5038

Authorized Official
Title or Position	:	MANAGING ADMINISTRATOR
Name	:	MARGARET KAPASI
Credential	:
Telephone Number	:	916-501-0728

Provider Enumeration Date	:	09/09/2009
Last Update Date	:	03/14/2012

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