| Amethyst Medical Group | |
|
590 Searls Ave Suite A Nevada City CA 95959-3043 | |
| (530) 798-5003 | |
| (530) 271-2338 |
| Full Name | Amethyst Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 590 Searls Ave, Nevada City, California |
| Authorized Official Name and Position | Winifred Myrna Loesch (PRESIDENT) |
| Authorized Official Contact | 5307985003 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Amethyst Medical Group 590 Searls Ave Suite A Nevada City CA 95959-3043 Ph: (530) 798-5003 | Amethyst Medical Group 590 Searls Ave Suite A Nevada City CA 95959-3043 Ph: (530) 798-5003 |
| NPI Number | 1194836338 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 08/19/2010 |
| Medicare PECOS PAC ID | 9133157431 |
|---|---|
| Medicare Enrollment ID | O20050728000579 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194836338 | NPI | - | NPPES |
| 00C422920 | Other | CA | PPIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | C42292 (California) | Primary |
| Provider Name | Jodi D Snyder |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1427013259 PECOS PAC ID: 1557340635 Enrollment ID: I20040714000764 |
| Provider Name | Winifred M Loesch |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1891761854 PECOS PAC ID: 3173425014 Enrollment ID: I20101018000729 |
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