| Live Oak Medical Clinic | |
|
5730 Packard Ave Ste 600 Marysville CA 95901-7118 | |
| (530) 741-6245 | |
| (530) 743-5044 |
| Full Name | Live Oak Medical Clinic |
|---|---|
| Speciality | Family Medicine |
| Location | 5730 Packard Ave, Marysville, California |
| Authorized Official Name and Position | Joseph M Coulter (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5307416245 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Live Oak Medical Clinic 5730 Packard Ave Ste 600 Marysville CA 95901-7118 Ph: (530) 741-6245 | Live Oak Medical Clinic 5730 Packard Ave Ste 600 Marysville CA 95901-7118 Ph: (530) 741-6245 |
| NPI Number | 1912165887 |
|---|---|
| Provider Enumeration Date | 05/28/2008 |
| Last Update Date | 05/28/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912165887 | NPI | - | NPPES |
| 1316096894 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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