| |
239 W Court St Woodland CA 95695-2900 | |
(530) 668-2656 | |
(530) 662-4527 |
Full Name | |
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Speciality | Clinic/center - Multi-specialty |
Location | 239 W Court St, Woodland, California |
Authorized Official Name and Position | Theresa M Hylen (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 9168512559 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1321 Cottonwood St Woodland CA 95695-5131 Ph: (530) 666-1631 | 239 W Court St Woodland CA 95695-2900 Ph: (530) 668-2656 |
NPI Number | 1881711547 |
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Provider Enumeration Date | 03/26/2007 |
Last Update Date | 11/18/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881711547 | NPI | - | NPPES |
GR0091674 | Medicaid | CA | |
ZZZ52383Z | Other | CA | BLUE SHIELD |
GR0013030 | Medicaid | CA | |
571205856 | Other | IRS |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
Molina Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Court St, Woodland, CA 95695 Phone: 530-668-9293 Fax: 530-668-0231 | |
Northern Valley Indian Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1280 E Gibson Rd, Woodland, CA 95776 Phone: 530-207-5499 | |