Fairchild Medical Center | |
444 Bruce St Yreka CA 96097-3450 | |
(530) 842-4121 | |
(530) 841-6242 |
Full Name | Fairchild Medical Center |
---|---|
Speciality | General Acute Care Hospital |
Location | 444 Bruce St, Yreka, California |
Authorized Official Name and Position | Jonathon C Andrus (CHEIF EXECUTIVE OFFICER) |
Authorized Official Contact | 5308416200 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Fairchild Medical Center 444 Bruce St Yreka CA 96097-3450 Ph: (530) 842-4121 | Fairchild Medical Center 444 Bruce St Yreka CA 96097-3450 Ph: (530) 842-4121 |
NPI Number | 1093892275 |
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Provider Enumeration Date | 11/01/2006 |
Last Update Date | 12/14/2015 |
Medicare PECOS PAC ID | 1254223134 |
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Medicare Enrollment ID | O20040927000311 |
Identifier | Type | State | Issuer |
---|---|---|---|
1093892275 | NPI | - | NPPES |
HSP40217F | Medicaid | CA | |
058634 | Medicaid | CA | |
ZZR00217F | Medicaid | CA | |
ZZZJ4702Z | Other | CA | BLUE SHIELD |
Provider Name | Paul Beatty |
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Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1932110160 PECOS PAC ID: 5092624916 Enrollment ID: I20040216000512 |
Provider Name | Juk L Ting |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1699713974 PECOS PAC ID: 3779486204 Enrollment ID: I20040301001214 |
Provider Name | Harry D Elshire |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1376618389 PECOS PAC ID: 2163410721 Enrollment ID: I20040506000442 |
Provider Name | Scott T Landeck |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1790733269 PECOS PAC ID: 9830091578 Enrollment ID: I20040513000609 |
Provider Name | Greg A Greenberg |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1013927441 PECOS PAC ID: 5395720791 Enrollment ID: I20040825000931 |
Provider Name | Walter L Wynne |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1396797817 PECOS PAC ID: 2668441379 Enrollment ID: I20040929000848 |
Provider Name | Keith J Ure |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1548261225 PECOS PAC ID: 3870548142 Enrollment ID: I20050318000895 |
Provider Name | Paul Marchand |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1952344186 PECOS PAC ID: 2062457229 Enrollment ID: I20050628000489 |
Provider Name | Michael J Nisco |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1538159124 PECOS PAC ID: 0244200418 Enrollment ID: I20051004001131 |
Provider Name | Samuel C Rabinowitz |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1497844088 PECOS PAC ID: 0749205987 Enrollment ID: I20051006001038 |
Provider Name | Andrew L Ralston |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1295793404 PECOS PAC ID: 7719902303 Enrollment ID: I20051012001067 |
Provider Name | Bruce N Riger |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1124023486 PECOS PAC ID: 5395761951 Enrollment ID: I20051021000912 |
Provider Name | Daniel William Bullock |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1952383929 PECOS PAC ID: 7214946417 Enrollment ID: I20060419000830 |
Provider Name | Joel B Younger |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1023088127 PECOS PAC ID: 9537129705 Enrollment ID: I20060712000333 |
Provider Name | Salah Sherif |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1790758530 PECOS PAC ID: 4284616046 Enrollment ID: I20071207000638 |
Provider Name | Kathleen Edmunds |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1619055696 PECOS PAC ID: 3173567252 Enrollment ID: I20080123000924 |
Provider Name | Wilfred W Eastman |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1437129939 PECOS PAC ID: 0446333884 Enrollment ID: I20080208000256 |
Provider Name | Steven J Scharpf |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1063466704 PECOS PAC ID: 9931283868 Enrollment ID: I20080229000623 |
Provider Name | Richard E Swenson |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1043301732 PECOS PAC ID: 0446339675 Enrollment ID: I20080429000929 |
Provider Name | Vina K Swenson |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1447341995 PECOS PAC ID: 1355420589 Enrollment ID: I20080613000174 |
Provider Name | Louis F Derouchey |
---|---|
Provider Type | Practitioner - General Practice |
Provider Identifiers | NPI Number: 1407850498 PECOS PAC ID: 0042300014 Enrollment ID: I20081114000137 |
Provider Name | Christal J Duncan |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1669476578 PECOS PAC ID: 0042373342 Enrollment ID: I20090113000545 |
Provider Name | Todd K Mcallister |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1164652319 PECOS PAC ID: 4981742673 Enrollment ID: I20091118000283 |
Provider Name | Rajwinder S Bahia |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1467695452 PECOS PAC ID: 8729128152 Enrollment ID: I20091216000316 |
Provider Name | Catherine C Olivolo |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1710035993 PECOS PAC ID: 6800931650 Enrollment ID: I20100303001065 |
Provider Name | John Benjamin Tribble |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1518164474 PECOS PAC ID: 8921134586 Enrollment ID: I20100407000513 |
Provider Name | Judy P Broeckel |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1831116821 PECOS PAC ID: 3870627383 Enrollment ID: I20100819000778 |
Provider Name | Asish Ghoshal |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1700087145 PECOS PAC ID: 5698956431 Enrollment ID: I20110225000817 |
Provider Name | Serena Ackerman |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1881899755 PECOS PAC ID: 5597857276 Enrollment ID: I20110303000183 |
Provider Name | Pascal R. Fuchshuber |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1295885002 PECOS PAC ID: 7012190465 Enrollment ID: I20110323000507 |
Provider Name | Muhammad Z Uddin |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1972709798 PECOS PAC ID: 9830368356 Enrollment ID: I20110817000742 |
Provider Name | Kareena L Walter |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1457566275 PECOS PAC ID: 8729259940 Enrollment ID: I20110920000662 |
Provider Name | Cynthia A Tuttle |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1548327281 PECOS PAC ID: 8022280817 Enrollment ID: I20111021000191 |
Provider Name | Robert K Evans |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1730134404 PECOS PAC ID: 9739112921 Enrollment ID: I20120131000772 |
Provider Name | Jawad Arif |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1245405000 PECOS PAC ID: 9739205246 Enrollment ID: I20120315000876 |
Provider Name | Katherine A Wagner |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1538446117 PECOS PAC ID: 2264695121 Enrollment ID: I20120514000319 |
Provider Name | Pedro Campos |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1760755086 PECOS PAC ID: 9931362753 Enrollment ID: I20120515000186 |
Provider Name | Paul V Beck |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1700921103 PECOS PAC ID: 9436315215 Enrollment ID: I20120723000834 |
Provider Name | Ethan Ross |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1780848507 PECOS PAC ID: 0547419681 Enrollment ID: I20121004000278 |
Provider Name | Thomas G Merry |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1689648719 PECOS PAC ID: 4284639576 Enrollment ID: I20121108000492 |
Provider Name | Michel-ann Dias |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1154557890 PECOS PAC ID: 0840439444 Enrollment ID: I20130611000616 |
Provider Name | Jon L Wilton |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1124357884 PECOS PAC ID: 9335052802 Enrollment ID: I20131227001781 |
Provider Name | Shaji Skaria |
---|---|
Provider Type | Practitioner - Pulmonary Disease |
Provider Identifiers | NPI Number: 1699971432 PECOS PAC ID: 7315063104 Enrollment ID: I20140722000342 |
Provider Name | Nathan H Parker |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1881987436 PECOS PAC ID: 2961629076 Enrollment ID: I20140813002989 |
Provider Name | Monica K Mais |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1902233349 PECOS PAC ID: 7618290305 Enrollment ID: I20150105001657 |
Provider Name | Cameron Lovinger |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1336537174 PECOS PAC ID: 7911223524 Enrollment ID: I20150225001878 |
Provider Name | Jeffrey C Evans |
---|---|
Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1255462370 PECOS PAC ID: 4486759636 Enrollment ID: I20150303002104 |
Provider Name | Aaron M Stutz |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1174851901 PECOS PAC ID: 7911223185 Enrollment ID: I20150305001067 |
Provider Name | Christa L Fournier |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1669897542 PECOS PAC ID: 1658699285 Enrollment ID: I20150411000005 |
Provider Name | Aditi B Bhaduri |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1114029329 PECOS PAC ID: 2668417569 Enrollment ID: I20151013001026 |
Provider Name | Charity A Bradley |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093197790 PECOS PAC ID: 1355643131 Enrollment ID: I20160111002446 |
Provider Name | Erin K Conroy |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1669731329 PECOS PAC ID: 9739475286 Enrollment ID: I20160908002338 |
Provider Name | Jennifer L Caris |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1649204975 PECOS PAC ID: 2769495118 Enrollment ID: I20161027001518 |
Provider Name | Faisal Ahmed |
---|---|
Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1417069881 PECOS PAC ID: 4587718028 Enrollment ID: I20170418002566 |
Provider Name | Brenda B Spriggs |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1720323355 PECOS PAC ID: 2769750926 Enrollment ID: I20170613001393 |
Provider Name | Samuel C Birkholz |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1558873786 PECOS PAC ID: 6305103136 Enrollment ID: I20171201002078 |
Provider Name | Mohammed S Akram |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1619921806 PECOS PAC ID: 0941213300 Enrollment ID: I20171228000396 |
Provider Name | Carolina Mona-keene |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1255845319 PECOS PAC ID: 9436419355 Enrollment ID: I20180213003011 |
Provider Name | Rebekah J Cummings |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1316198344 PECOS PAC ID: 2062573967 Enrollment ID: I20181023001560 |
Provider Name | Jon Hopkins |
---|---|
Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1629459607 PECOS PAC ID: 8729331442 Enrollment ID: I20181026001377 |
Provider Name | Moudy S Youssef |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1881743409 PECOS PAC ID: 0547244097 Enrollment ID: I20190227000351 |
Provider Name | Dana W Detwiler |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1275901738 PECOS PAC ID: 9638439524 Enrollment ID: I20190531001058 |
Provider Name | Joann Smith |
---|---|
Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1336586999 PECOS PAC ID: 2163756206 Enrollment ID: I20190625000267 |
Provider Name | Kasia N Mannix |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1588996060 PECOS PAC ID: 7810223849 Enrollment ID: I20190729001109 |
Provider Name | Christopher Rackoff |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1255765657 PECOS PAC ID: 8921393828 Enrollment ID: I20190829002068 |
Provider Name | Brant E Kirk |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1477843605 PECOS PAC ID: 0749578912 Enrollment ID: I20191204001727 |
Provider Name | Robert Dale Reynolds |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1740821099 PECOS PAC ID: 0446683205 Enrollment ID: I20191209001848 |
Provider Name | Jacob H Wolf |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1801445077 PECOS PAC ID: 5092149377 Enrollment ID: I20191218003215 |
Provider Name | Maya S Belitski |
---|---|
Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1649465741 PECOS PAC ID: 4183052756 Enrollment ID: I20200312001819 |
Provider Name | Jodi B Nagelberg |
---|---|
Provider Type | Practitioner - Endocrinology |
Provider Identifiers | NPI Number: 1720474141 PECOS PAC ID: 8921384116 Enrollment ID: I20200820001255 |
Provider Name | Piyush Gupta |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1275618803 PECOS PAC ID: 9830369040 Enrollment ID: I20200825000299 |
Provider Name | Kien T Tran |
---|---|
Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1821073297 PECOS PAC ID: 0143233387 Enrollment ID: I20201223001465 |
Provider Name | Scott David Beer |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1548859341 PECOS PAC ID: 6204242340 Enrollment ID: I20210315002490 |
Provider Name | Jessie K Hermant |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1225516537 PECOS PAC ID: 4183961774 Enrollment ID: I20210514002518 |
Provider Name | Junaid Kalia |
---|---|
Provider Type | Practitioner - Neurology |
Provider Identifiers | NPI Number: 1790096998 PECOS PAC ID: 9830485614 Enrollment ID: I20210518002228 |
Provider Name | Sarah J Norris |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1215216643 PECOS PAC ID: 7719109040 Enrollment ID: I20210524002888 |
Provider Name | Ricardo A Noble |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1306209762 PECOS PAC ID: 6204120694 Enrollment ID: I20211102001838 |
Provider Name | Diane F Godorov |
---|---|
Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1942377015 PECOS PAC ID: 7315042348 Enrollment ID: I20211103001625 |
Provider Name | Louis H Grass |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1114298338 PECOS PAC ID: 2668730326 Enrollment ID: I20220204002190 |
Provider Name | Debra M Lowry |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1295933190 PECOS PAC ID: 6002295417 Enrollment ID: I20220615000895 |
Provider Name | Ashlie Nicole White |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1629338835 PECOS PAC ID: 5395088918 Enrollment ID: I20220801000728 |
Provider Name | Patricia Louise Kulbeth |
---|---|
Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1821338112 PECOS PAC ID: 4688005853 Enrollment ID: I20220809003837 |
Provider Name | Carrie C Mcneely |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1386309623 PECOS PAC ID: 0749664183 Enrollment ID: I20220901003683 |
Provider Name | Sharon L Heichman |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1316443757 PECOS PAC ID: 5092181834 Enrollment ID: I20221019000334 |
Provider Name | Lisa Di Tomaso |
---|---|
Provider Type | Practitioner - Osteopathic Manipulative Medicine |
Provider Identifiers | NPI Number: 1750843397 PECOS PAC ID: 8628446838 Enrollment ID: I20221118002684 |
Provider Name | Nino N Pitiuri |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1518454917 PECOS PAC ID: 7214306455 Enrollment ID: I20221212000683 |
Provider Name | Scott Charles Epperly |
---|---|
Provider Type | Practitioner - Orthopedic Surgery |
Provider Identifiers | NPI Number: 1356798938 PECOS PAC ID: 7214332394 Enrollment ID: I20221216002124 |
Provider Name | Jason L Trudell |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1518078724 PECOS PAC ID: 8729183751 Enrollment ID: I20221221000767 |
Provider Name | David E Marriott |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1194213678 PECOS PAC ID: 2163823352 Enrollment ID: I20221221003133 |
Provider Name | Heather A Huston |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1861100653 PECOS PAC ID: 1850318833 Enrollment ID: I20230120001523 |
Provider Name | Craig B Cade |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1134173370 PECOS PAC ID: 5698721926 Enrollment ID: I20230217000308 |
Provider Name | Irony Sade |
---|---|
Provider Type | Practitioner - General Surgery |
Provider Identifiers | NPI Number: 1639478290 PECOS PAC ID: 5991079493 Enrollment ID: I20230217001513 |
Provider Name | Jennifer Caldwell Hall |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1629117668 PECOS PAC ID: 0648337964 Enrollment ID: I20230301001046 |
Provider Name | Michael Fusaro |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1194109785 PECOS PAC ID: 0345546511 Enrollment ID: I20230413000513 |
Provider Name | Kathleen Brandt |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1841990603 PECOS PAC ID: 7517323660 Enrollment ID: I20230516003059 |
Provider Name | Ernest J Rin |
---|---|
Provider Type | Practitioner - Emergency Medicine |
Provider Identifiers | NPI Number: 1023578101 PECOS PAC ID: 9032595871 Enrollment ID: I20230519001364 |
Provider Name | Corenna M Mitcham |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1831471184 PECOS PAC ID: 5395101117 Enrollment ID: I20230522002045 |
Provider Name | Ryan Knight |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1568067981 PECOS PAC ID: 5395102057 Enrollment ID: I20230612001392 |
Provider Name | Roy E Smith |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1245287291 PECOS PAC ID: 7416928270 Enrollment ID: I20240109004078 |
Provider Name | Nisha Kotecha |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1093144719 PECOS PAC ID: 1658503420 Enrollment ID: I20240110002215 |
Provider Name | Megan L Prange |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1700409141 PECOS PAC ID: 6901227404 Enrollment ID: I20240117003146 |
Provider Name | April J Gray |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1427784586 PECOS PAC ID: 9739531567 Enrollment ID: I20240117003644 |
Provider Name | Joshua Wolf |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1649274333 PECOS PAC ID: 0244126407 Enrollment ID: I20240228002733 |
Provider Name | Denise I Fitzsimon |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1861525636 PECOS PAC ID: 1153412523 Enrollment ID: I20240320003203 |
Provider Name | Wendy Christine Slabaugh |
---|---|
Provider Type | Practitioner - Certified Registered Nurse Anesthetist (crna) |
Provider Identifiers | NPI Number: 1861764334 PECOS PAC ID: 4385804178 Enrollment ID: I20240503003432 |
Provider Name | Luisa M Cabebe |
---|---|
Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1194353508 PECOS PAC ID: 6800237462 Enrollment ID: I20240514000948 |
John D. Durney D.d.s., A Professional Dental Corporation Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 303 Yreka St, Yreka, CA 96097 Phone: 530-842-2427 Fax: 530-841-0733 | |
Trevor L. Ragan, Dds, Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 444 W Miner St, Yreka, CA 96097 Phone: 530-842-7323 | |
Family Smiles Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 444 W Miner St, Yreka, CA 96097 Phone: 530-842-7323 Fax: 530-842-4320 | |
Randy D. Krant, Dds Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 310 Evergreen Ln, Yreka, CA 96097 Phone: 530-842-2558 Fax: 530-842-9011 |