Organization
CREATIVE CLINICAL RESEARCH, INC.
Active
Other names
Elk Grove Clinical Research
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KIRK JAY AUSTIN PA (CEO)
(916) 513-7027
Entity
Organization
Contact information
Practice address
930 ALHAMBRA BLVD STE 230, SACRAMENTO, CA 95816-4433
(916) 385-4438
Mailing address
7807 LAGUNA BLVD STE 480, ELK GROVE, CA 95758-7953
(916) 513-7027
(916) 895-2184
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1124313093
—
CA
05
—
1689712317
—
CA
05
—
1962848374
—
CA
Enumeration date
05/18/2017
Last updated
07/21/2022
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