| Pine Street Clinic | |
|
145 N Pine St Portola CA 96122-8415 | |
| (530) 832-6500 | |
| Not Available |
| Full Name | Pine Street Clinic |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 145 N Pine St, Portola, California |
| Authorized Official Name and Position | Thomas Hayes (CEO) |
| Authorized Official Contact | 5308326564 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Pine Street Clinic 500 1st Ave Portola CA 96122-9406 Ph: (530) 832-6500 | Pine Street Clinic 145 N Pine St Portola CA 96122-8415 Ph: (530) 832-6500 |
| NPI Number | 1073990925 |
|---|---|
| Provider Enumeration Date | 04/29/2015 |
| Last Update Date | 07/30/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073990925 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 230000014 (California) | Primary |
Eastern Plumas Health Care District Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 480 1st Ave, Portola, CA 96122 Phone: 530-832-6500 Fax: 530-832-1105 |