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FOLSOM FAMILY AND SPORTS MEDICAL GROUP INC.
NPI 1629372073
Family Medicine in Folsom, CA

Active since December 28, 2010
2545 E BIDWELL ST STE 110, FOLSOM, CA 95630(916) 941-7362(866) 779-3899 Get Directions Write a Review

NPPES record last updated: December 31, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Dec 31, 2024, Jul 20, 2022, Mar 27, 2017 (3 updates tracked since 2017).

About Folsom Family And Sports Medical Group Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FOLSOM FAMILY AND SPORTS MEDICAL GROUP INC. (NPI 1629372073) is a healthcare organization registered as a family medicine in Folsom, California and active in the NPI registry since December 2010. The organization lists Melanie Miller, Manager, as its authorized official.

NPPES Registry Identity

NPI1629372073
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameFOLSOM FAMILY AND SPORTS MEDICAL GROUP INC.
Location Address2545 E BIDWELL ST STE 110Folsom, CA 95630-6443
Mailing Address2545 E Bidwell St Ste 110Folsom, CA 95630-6443 · (916) 941-7362 · Fax (866) 779-3899
Phone(916) 941-7362
Fax(866) 779-3899
Organization SubpartNo
Authorized OfficialMelanie MillerManager · (916) 365-3431
Enumeration DateDecember 28, 2010
Last NPPES UpdateDecember 31, 20243 updates tracked since enumeration
NPPES CertifiedDecember 31, 2024
✔ NPI 1629372073 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in CA · A64163
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Also ListedClinic/Center · Primary CareTaxonomy 261QP2300X
2545 E BIDWELL ST STE 110, Folsom, CA 95630
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 05D1022044

Folsom Family And Sports Medical Group Inc · Folsom, CA
Expired · Jul 27, 2026
CLIA Number05D1022044
Laboratory TypePhysician Office
Certificate Effective DateJuly 28, 2024
Certificate Expiration DateJuly 27, 2026
Laboratory DirectorCheryl A. Matossian
Laboratory Phone(916) 941-7362
Laboratory LocationFolsom Family And Sports Medical Group Inc2545 E Bidwell St, Ste 110, Folsom, CA 95630
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

KELLEY MANION LEONARD CRNP
Nurse Practitioner (Family)
2545 E BIDWELL ST STE 110
FOLSOM, CA 95630
Sacramento County (916) 941-7362
DR. GINA TOBALINA MD
Family Medicine
2545 E BIDWELL ST STE 110
FOLSOM, CA 95630
Sacramento County (916) 817-4132
DR. CHERYL ANN MATOSSIAN M.D.
Family Medicine (Sports Medicine)
2545 E BIDWELL ST STE 110
FOLSOM, CA 95630
Sacramento County (916) 941-7362

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Folsom Family And Sports Medical Group Inc.'s NPI number?

The NPI number for Folsom Family And Sports Medical Group Inc. is 1629372073. It was assigned to this organization in the NPPES registry on December 28, 2010.

Where is Folsom Family And Sports Medical Group Inc. located?

Folsom Family And Sports Medical Group Inc. is located at 2545 E Bidwell St Ste 110, Folsom, CA 95630. The listed phone number is (916) 941-7362.

What is Folsom Family And Sports Medical Group Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Folsom Family And Sports Medical Group Inc. was last updated on December 31, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.