Healthcare Provider Details

I. General information

NPI: 1376676569
Provider Name (Legal Business Name): COLUSA REGIONAL MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

199 E WEBSTER ST
COLUSA CA
95932-2954
US

IV. Provider business mailing address

199 E WEBSTER ST
COLUSA CA
95932-2954
US

V. Phone/Fax

Practice location:
  • Phone: 530-458-5821
  • Fax: 530-458-3230
Mailing address:
  • Phone: 530-458-5821
  • Fax: 530-458-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282N00000X
TaxonomyGeneral Acute Care Hospital
License Number
License Number StateCA

VIII. Authorized Official

Name: SHAKILA DEVI NARAYAN
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 530-458-5821