Healthcare Provider Details

I. General information

NPI: 1023420726
Provider Name (Legal Business Name): ENLOE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2014
Last Update Date: 01/08/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1665 ESPLANADE
CHICO CA
95926-3312
US

IV. Provider business mailing address

1531 ESPLANADE ATTN: FINANCE
CHICO CA
95926-3310
US

V. Phone/Fax

Practice location:
  • Phone: 530-895-0423
  • Fax: 530-895-1872
Mailing address:
  • Phone: 530-332-7479
  • Fax: 530-893-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number230000027
License Number StateCA

VIII. Authorized Official

Name: CHRISTINE VENARD
Title or Position: DIRECTOR, PFS
Credential:
Phone: 530-332-6331