Taa-'at-dvn is a medicare enrolled "Clinic/center - Primary Care" provider in Crescent City, California. Their current practice location is
1675 Northcrest Dr, Crescent City, California. You can reach out to their office (for appointments etc.) via phone at
(707) 464-2750.
Taa-'at-dvn is licensed to practice in * (Not Available) (license number ) and it also participates in the medicare program. Taa-'at-dvn
is enrolled with medicare and should accept medicare assignments and since they are enrolled in medicare, they may order Medicare Part D Prescription drugs, if eligible. The facility's NPI Number is 1043216021.
Healthcare Provider's Profile
| Full Name | Taa-'at-dvn |
|---|
| Type | Facility |
|---|
| Speciality | Clinic/center - Primary Care |
|---|
| Location | 1675 Northcrest Dr, Crescent City, California |
|---|
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
|---|
NPI Data:
- NPI Number: 1043216021
- Provider Enumeration Date: 06/23/2005
- Last Update Date: 11/16/2022
Medicare PECOS Information:
- PECOS PAC ID: 9830085075
- Enrollment ID: O20090408000477
Medical Identifiers
Medical identifiers for Taa-'at-dvn such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043216021 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 152W00000X | Optometrist | (* (Not Available)) | Secondary |
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Secondary |
| 261QC1500X | Clinic/center - Community Health | EXEMPT (California) | Secondary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Taa-'at-dvn is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Taa-'at-dvn
1600 Weeot Way,
Arcata, CA 95521-4734
Ph: (707) 825-5000 | Taa-'at-dvn
1675 Northcrest Dr,
Crescent City, CA 95531-8928
Ph: (707) 464-2750 |
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