Healthcare Provider Details

I. General information

NPI: 1770905994
Provider Name (Legal Business Name): ENLOE MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/07/2014
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 ESPLANADE SUITE C
CHICO CA
95926-3369
US

IV. Provider business mailing address

1531 ESPLANADE ATTN: FINANCE
CHICO CA
95926-3310
US

V. Phone/Fax

Practice location:
  • Phone: 530-332-7300
  • Fax: 530-893-6885
Mailing address:
  • Phone: 530-332-7300
  • Fax: 530-893-6853

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number230000027
License Number StateCA

VIII. Authorized Official

Name: MYRON MACHULA
Title or Position: VP/CFO
Credential:
Phone: 530-332-7357