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1065 Bucks Lake Rd Quincy CA 95971-9507 | |
(530) 283-7161 | |
(530) 283-7953 |
Full Name | |
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Speciality | Clinic/Center |
Location | 1065 Bucks Lake Rd, Quincy, California |
Authorized Official Name and Position | Jeffrey Kepple (CEO) |
Authorized Official Contact | 5302837127 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1065 Bucks Lake Rd Quincy CA 95971-9507 Ph: (530) 283-7161 | 1065 Bucks Lake Rd Quincy CA 95971-9507 Ph: (530) 283-7161 |
NPI Number | 1043348543 |
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Provider Enumeration Date | 02/28/2007 |
Last Update Date | 12/08/2015 |
Medicare PECOS PAC ID | 8224930466 |
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Medicare Enrollment ID | O20110114000602 |
Identifier | Type | State | Issuer |
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1043348543 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 230000030 (California) | Primary |