| Lake County Tribal Health Middletown Clinic | |
|
22223 Ca-29 Rancheria Road, Tribal Offices #1035 Middletown CA 95461 | |
| (707) 263-8382 | |
| Not Available |
| Full Name | Lake County Tribal Health Middletown Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 22223 Ca-29, Middletown, California |
| Authorized Official Name and Position | Thomas Burnett (EHR SPECIALIST) |
| Authorized Official Contact | 7072638382 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lake County Tribal Health Middletown Clinic Po Box 1950 Lakeport CA 95453-1950 Ph: () - | Lake County Tribal Health Middletown Clinic 22223 Ca-29 Rancheria Road, Tribal Offices #1035 Middletown CA 95461 Ph: (707) 263-8382 |
| NPI Number | 1982418430 |
|---|---|
| Provider Enumeration Date | 02/05/2025 |
| Last Update Date | 02/05/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982418430 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |