Healthcare Provider Details

I. General information

NPI: 1326989666
Provider Name (Legal Business Name): CODY MCELWAIN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2026
Last Update Date: 04/02/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 1ST STREET
HAMILTON CITY CA
95951
US

IV. Provider business mailing address

420 1ST STREET
HAMILTON CITY CA
95951
US

V. Phone/Fax

Practice location:
  • Phone: 530-844-0131
  • Fax:
Mailing address:
  • Phone: 530-844-0131
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP45638
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: