Healthcare Provider Details

I. General information

NPI: 1578577490
Provider Name (Legal Business Name): PIXLEY MEDICAL CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 04/12/2024
Certification Date: 04/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 EAST DAVIS
PIXLEY CA
93256
US

IV. Provider business mailing address

PO BOX DRAWER Y 205 EAST DAVIS
PIXLEY CA
93256
US

V. Phone/Fax

Practice location:
  • Phone: 559-757-2000
  • Fax: 559-757-2006
Mailing address:
  • Phone: 559-757-2000
  • Fax: 559-757-2006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License NumberRHM53825G
License Number StateCA

VIII. Authorized Official

Name: LINDA ROBERTS
Title or Position: CEO OWNER
Credential: RN
Phone: 559-752-4147