CREEKSIDE SURGERY SUITE (NPI# 1326374844) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326374844 |
| Entity Type | Organization |
| Organization Name | CREEKSIDE SURGERY SUITE |
| Practice Address |
1561 Creekside Dr Suite 110 Folsom CA 95630-3492 |
| Practice Telephone | 9169841600 |
| Practice Fax Number | 9169841616 |
| Mailing Telephone | 9169841600 |
| Mailing Fax Number | 9169841616 |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-10-19 |
| Authorized Official Name | DR. SHAHRIAR MABOURAKH (MEDICAL DIRECTOR) |
| Authorized Official Telephone | 9169841600 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
10176 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | IMQ IDENTIFICATION NUMBER | 10176 | 01 |
| Street Address |
1561 CREEKSIDE DR SUITE 110 |
| City | FOLSOM |
| State | CA |
| Zip Code | 95630-3492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497791487 | Shahriar Mabourakh | Plastic Surgery | 1561 Creekside Dr, Suite 110, Folsom, CA 95630-3492 | 2006-06-20 |
| 1063761237 | Denise Kathleen Hopkins | Physician Assistant | 1561 Creekside Dr, Folsom, CA 95630-3492 | 2012-09-04 |
| 1245558923 | Kelli Carver | Physician Assistant | 1561 Creekside Dr, #150, Folsom, CA 95630-3492 | 2010-05-05 |
| 1932348638 | Radiological Associates of Sacramento Medical Group Inc | Urology | 1561 Creekside Dr, Suite 170, Folsom, CA 95630-3492 | 2009-02-19 |
| 1538209663 | Greater Sacramento Pediatrics Association Inc | Clinic/Center | 1561 Creekside Dr, Suite 140, Folsom, CA 95630-3492 | 2007-02-07 |
| 1306867213 | Capitol Urology Medical Group Inc | Clinic/Center | 1561 Creekside Dr, Suite 170, Folsom, CA 95630 | 2006-07-23 |
| 1295768737 | Medical Vision Technology Ophthalmology Group, Inc. | Ophthalmology | 1561 Creekside Dr, Suite 160, Folsom, CA 95630-3492 | 2006-07-08 |
| 1336176312 | Cecille G Taylor | Ophthalmology | 1561 Creekside Dr, #160, Folsom, CA 95630 | 2006-06-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831724657 | Corrections and Rehabilitation | Pharmacy | 570 E. Natoma Street, Folsom, CA 95630 | 2020-03-12 |
| 1174153027 | Haley Harmon | Nurse Practitioner | 1621 Creekside Dr. Creekside Ob/gyn, Ste. 102, Folsom, CA 95630 | 2020-01-20 |
| 1932741469 | Ruma Ramani Jolly | Speech-Language Pathologist | 250 Mc Adoo Drive, Willow Springs, Apt.911, Folsom, CA 95630 | 2019-10-16 |
| 1750844767 | Sharon Munyaanyi | Registered Nurse | 1600 Creekside Dr Ste 3700, Folsom, CA 95630 | 2019-04-08 |
| 1104308345 | Stephanie Whatley | Optometrist | 2390 E Bidwell St Ste 400, Folsom, CA 95630 | 2018-09-04 |
| 1447746607 | Heather Michellee Thrapp | Behavioral Analyst | 125 Oak Ravine Way, Folsom, CA 95630 | 2018-07-10 |
| 1700370483 | Loretta May Delgado | Behavior Technician | 322 Crow Cany, Folsom, CA 95630 | 2018-06-18 |
| 1417448176 | Sound Support Inc. | Hearing Instrument Specialist | 610 East Bidwell Street, Suite A, Folsom, CA 95630 | 2018-05-29 |
| 1548750144 | Don Peterson Md, Sugical Assisting | General Practice | Mercy Hospital of Folsom (dignity Health Folsom), 1650 Creekside Dr., Folsom, CA 95630 | 2018-05-18 |
| 1245733328 | American Heritage Hospice Inc | Hospice Care, Community Based | 1837 Iron Point Rd Ste 180, Folsom, CA 95630 | 2018-03-14 |
| Find all providers in zip 95630 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538664339 | Folsom Endoscopy Center LLC | Clinic/Center | 1671 Creekside Dr Ste 100, Folsom, CA 95630-3890 | 2018-03-26 |
| 1124273685 | Aesthetic Artistry Surgical and Medical Center LLC | Clinic/Center | 1841 Iron Point Rd, Folsom, CA 95630-8838 | 2008-11-25 |
| 1942278692 | Folsom Outpatient Surgery Center, Lp | Clinic/Center | 1651 Creekside Dr, Ste 100, Folsom, CA 95630 | 2006-03-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790384303 | Abroms Dougherty Vision Asc LLC | Clinic/Center | 4472 Broad St Ste 150, San Luis Obispo, CA 93401-7933 | 2020-10-23 |
| 1861091993 | Willow Vista Surgical Center | Clinic/Center | 39810 Portola Ave, Palm Desert, CA 92260-0624 | 2020-10-20 |
| 1366041469 | The Regents of The University of California | Clinic/Center | 4343 Lankershim Blvd Ste 210, North Hollywood, CA 91602-2705 | 2020-10-20 |
| 1609473420 | Alden Advanced Surgicenter LLC | Clinic/Center | 8741 Alden Drive, Suite B, Los Angeles, CA 90048 | 2020-10-05 |
| 1396352944 | Irvine Surgical Center LLC | Clinic/Center | 17624 Redhill Ave Ste B, Irvine, CA 92614 | 2020-09-28 |
| 1538775267 | Ev Surgery Institute LLC | Clinic/Center | 105 N Bascom Ave Ste 105, San Jose, CA 95128-1811 | 2020-09-18 |
| 1003420001 | On Beach Surgery Center, LLC | Clinic/Center | 5832 Beach Blvd, Suite 210, Buena Park, CA 90621 | 2020-09-07 |
| 1811501661 | Precision Surgical Arts | Clinic/Center | 20311 Sw Birch St Ste 201, Newport Beach, CA 92660-1777 | 2020-08-31 |
| 1205448750 | Elite Surgery Center of South Bay LLC | Clinic/Center | 20528 Hawthorne Blvd Ste 301, Torrance, CA 90503-3202 | 2020-08-17 |
| 1740891571 | Peninsula Surgery Center, LLC | Clinic/Center | 350 Marine Pkwy Ste 100, Redwood City, CA 94065-5224 | 2020-08-14 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.