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670 County Road 83 Canby CA 96015-9722 | |
(530) 233-4641 | |
(530) 233-2830 |
Full Name | |
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Speciality | Clinic/Center |
Location | 670 County Road 83, Canby, California |
Authorized Official Name and Position | Kevin Scott Kramer (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5307088801 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 190 Alturas CA 96101-0190 Ph: (530) 708-8801 | 670 County Road 83 Canby CA 96015-9722 Ph: (530) 233-4641 |
NPI Number | 1376164749 |
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Provider Enumeration Date | 04/27/2020 |
Last Update Date | 12/28/2022 |
Medicare PECOS PAC ID | 2466447412 |
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Medicare Enrollment ID | O20200622000712 |
Identifier | Type | State | Issuer |
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1376164749 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |