Provider Demographics
NPI:1144536707
Name:THE MEDIQWIK FOUNDATION
Entity type:Organization
Organization Name:THE MEDIQWIK FOUNDATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHAIRMAN
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ROY
Authorized Official - Last Name:SPRINGETT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:916-206-2566
Mailing Address - Street 1:1731 HOWE AVE
Mailing Address - Street 2:SUITE 238
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-2209
Mailing Address - Country:US
Mailing Address - Phone:916-206-2566
Mailing Address - Fax:916-484-1087
Practice Address - Street 1:1731 HOWE AVE
Practice Address - Street 2:SUITE 238
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-2209
Practice Address - Country:US
Practice Address - Phone:916-206-2566
Practice Address - Fax:916-484-1087
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CATBD261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care