Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 801 11th St, Lakeport, California |
Authorized Official Name and Position | Judson H.e. Howe (PRESIDENT) |
Authorized Official Contact | 7074563010 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 888837 Los Angeles CA 90088-8837 Ph: () - | 801 11th St Lakeport CA 95453-4100 Ph: (707) 263-3746 |
NPI Number | 1871063040 |
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Provider Enumeration Date | 11/30/2018 |
Last Update Date | 05/29/2024 |
Medicare PECOS PAC ID | 3072421197 |
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Medicare Enrollment ID | O20190318002699 |
Identifier | Type | State | Issuer |
---|---|---|---|
1871063040 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 1st St, Ste 210, Lakeport, CA 95453 Phone: 707-462-1516 Fax: 707-462-1178 | |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 11th St, Lakeport, CA 95453 Phone: 707-263-3746 | |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5108 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-1840 Fax: 707-262-5844 | |