K'imaw Medical Center | |
535 Airport Rd Hoopa CA 95546-9615 | |
(530) 625-4261 | |
(530) 625-9308 |
Full Name | K'imaw Medical Center |
---|---|
Speciality | Clinic/Center |
Location | 535 Airport Rd, Hoopa, California |
Authorized Official Name and Position | Emmett Chase (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5306254261 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
K'imaw Medical Center 535 Airport Road Po Box 1288 Hoopa CA 95546-1288 Ph: (530) 625-4261 | K'imaw Medical Center 535 Airport Rd Hoopa CA 95546-9615 Ph: (530) 625-4261 |
NPI Number | 1306904222 |
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Provider Enumeration Date | 12/04/2006 |
Last Update Date | 03/07/2023 |
Medicare PECOS PAC ID | 5496740698 |
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Medicare Enrollment ID | O20040416001480 |
Identifier | Type | State | Issuer |
---|---|---|---|
1306904222 | NPI | - | NPPES |
EAP11573F | Other | CA | EAPC |
PHE43666 | Other | CA | PHARMACY |
THP11573F | Medicaid | CA | |
05D0699458 | Other | CA | CLIA |
PHE436660 | Other | CA | PHARMACY MEDICAID NUMBER |
005540 | Other | CA | BC COUNTY MEDICAID |
0533922 | Other | CA | PHARMACY NABP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261Q00000X | Clinic/center | EXEMPT INDIAN TRIBE (California) | Primary |
Provider Name | Timothy C Paik Nicely |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1760489389 PECOS PAC ID: 6800797234 Enrollment ID: I20040117000200 |
Provider Name | Jennifer A Jackson |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1053579284 PECOS PAC ID: 7012964042 Enrollment ID: I20050401000578 |
Provider Name | Olatokunb M Ayoola Archie |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1891969572 PECOS PAC ID: 5395786370 Enrollment ID: I20050519000794 |
Provider Name | Eva Marie Smith |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1982773099 PECOS PAC ID: 9931194131 Enrollment ID: I20050610000602 |
Provider Name | Susan N Walsh |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1306915418 PECOS PAC ID: 6800820234 Enrollment ID: I20050923000961 |
Provider Name | May C Hong |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1811933690 PECOS PAC ID: 4587642657 Enrollment ID: I20080125000210 |
Provider Name | Victor Gregory Krall |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1386746477 PECOS PAC ID: 9638339401 Enrollment ID: I20120402000483 |
Provider Name | Christopher Voscopoulos |
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Provider Type | Practitioner - Anesthesiology |
Provider Identifiers | NPI Number: 1942475538 PECOS PAC ID: 9739358698 Enrollment ID: I20150911000830 |
Provider Name | James J Matsuda |
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Provider Type | Practitioner - Pediatric Medicine |
Provider Identifiers | NPI Number: 1720066061 PECOS PAC ID: 8325275001 Enrollment ID: I20180919002571 |
Provider Name | Tracy Marshall |
---|---|
Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1114463965 PECOS PAC ID: 5597197939 Enrollment ID: I20191122002310 |
Provider Name | Mark Rader |
---|---|
Provider Type | Practitioner - Obstetrics/gynecology |
Provider Identifiers | NPI Number: 1396734950 PECOS PAC ID: 1254223720 Enrollment ID: I20200323000266 |
Provider Name | Troy Bassiri |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1316475643 PECOS PAC ID: 3870861255 Enrollment ID: I20230925002432 |
Provider Name | Mark Y Liu |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1710967914 PECOS PAC ID: 8325041403 Enrollment ID: I20240213004404 |
Provider Name | Claudia Collins |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1780112094 PECOS PAC ID: 6002184397 Enrollment ID: I20240215001846 |
Hupa Health Association, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 535 Airport Rd Ste 104, Hoopa, CA 95546 Phone: 530-625-4585 Fax: 530-625-4312 | |
K'ima: W Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1200 Airportroad, Hoopa, CA 95546 Phone: 530-625-4261 Fax: 530-625-9308 | |
Hupa Health Association Inc Ambulance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 535 Airport Rd, Hoopa, CA 95546 Phone: 530-625-4261 Fax: 530-625-9308 |