| Surprise Valley Medical Clinic | |
|
745 Main Street Cedarville CA 96104 | |
| (530) 279-6111 | |
| (530) 279-2680 |
| Full Name | Surprise Valley Medical Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 745 Main Street, Cedarville, California |
| Authorized Official Name and Position | Wanda L Grove (ADMINISTRATOR) |
| Authorized Official Contact | 5302796111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Surprise Valley Medical Clinic Po Box 246 Cedarville CA 96104-0246 Ph: (530) 279-6111 | Surprise Valley Medical Clinic 745 Main Street Cedarville CA 96104 Ph: (530) 279-6111 |
| NPI Number | 1073693651 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 09/11/2013 |
| Medicare PECOS PAC ID | 1658368519 |
|---|---|
| Medicare Enrollment ID | O20100716000205 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073693651 | NPI | - | NPPES |
| BCP13983F | Medicaid | CA | |
| RHM13983F | Medicaid | CA | |
| HAP13983F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 230000025 (California) | Primary |
Pafford Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 519a Main Street, Cedarville, CA 96104 Phone: 530-279-2148 Fax: 530-240-6440 | |
Chuck R. Colas, D.o., P.c. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: #66, County Rd. 37 #6, Cedarville, CA 96104 Phone: 314-888-5233 Fax: 203-590-8644 |