MEDICARE: RIVER CITY MEDICAL GROUP, 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	251X00000X	Supports Brokerage Agency
2	171M00000X	Case Manager/Care Coordinator
3	171W00000X	Contractor
4	302F00000X	Exclusive Provider Organization	302F00000X	CA

General Provider Information

NPI Number	:	1538300686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	RIVER CITY MEDICAL GROUP, INC.

Provider Business Mailing Address
First Line	:	7311 GREENHAVEN DR STE 145
Second Line	:
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3595
Country	:	US
Telephone Number	:	916-228-4300
Fax Number	:

Provider Business Practice Location Address
First Line	:	7311 GREENHAVEN DRIVE
Second Line	:	SUITE 145
City	:	SACRAMENTO
State	:	CA
Zip	:	95831-3589
Country	:	US
Telephone Number	:	916-228-4300
Fax Number	:	916-424-6200

Authorized Official
Title or Position	:	CREDENTIALING MANAGER
Name	:	MISS AMY CLOTHIER
Credential	:
Telephone Number	:	916-228-4300

Provider Enumeration Date	:	03/19/2009
Last Update Date	:	01/02/2026

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Directions to “RIVER CITY MEDICAL GROUP, INC. ” Practice Location

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