Healthcare Provider Details

I. General information

NPI: 1447056908
Provider Name (Legal Business Name): COUNTY OF AMADOR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/24/2025
Last Update Date: 02/24/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 COURT STREET
JACKSON CA
95642
US

IV. Provider business mailing address

700 COURT STREET
JACKSON CA
95642
US

V. Phone/Fax

Practice location:
  • Phone: 209-223-6500
  • Fax:
Mailing address:
  • Phone: 209-223-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ADAM STONE
Title or Position: CAPTAIN
Credential:
Phone: 209-223-6369