Coarsegold Creek Medical Center | |
35463 Highway 41 Coarsegold CA 93614-8722 | |
(559) 683-6292 | |
Not Available |
Full Name | Coarsegold Creek Medical Center |
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Speciality | General Practice |
Location | 35463 Highway 41, Coarsegold, California |
Authorized Official Name and Position | Stephen Dahlin (OWNER) |
Authorized Official Contact | 5596836292 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Coarsegold Creek Medical Center Po Box 970 Coarsegold CA 93614-0970 Ph: (559) 683-6292 | Coarsegold Creek Medical Center 35463 Highway 41 Coarsegold CA 93614-8722 Ph: (559) 683-6292 |
NPI Number | 1629646161 |
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Provider Enumeration Date | 06/11/2021 |
Last Update Date | 06/11/2021 |
Medicare PECOS PAC ID | 9032514773 |
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Medicare Enrollment ID | O20210818004061 |
Identifier | Type | State | Issuer |
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1629646161 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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208D00000X | General Practice | (* (Not Available)) | Primary |
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Secondary |
Provider Name | Hannah Fouch |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1477224152 PECOS PAC ID: 0446632632 Enrollment ID: I20220804001927 |
Coarsegold Health Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 35324 Highway 41 Ste A, Coarsegold, CA 93614 Phone: 559-664-4000 |