Healthcare Provider Details

I. General information

NPI: 1518418862
Provider Name (Legal Business Name): ALLIANCE MEDICAL CENTER, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 07/30/2020
Certification Date: 07/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8499 OLD REDWOOD HWY SUITE 111 & 112
WINDSOR CA
95492-8056
US

IV. Provider business mailing address

8499 OLD REDWOOD HWY SUITE 111 & 112
WINDSOR CA
95492-8056
US

V. Phone/Fax

Practice location:
  • Phone: 707-433-5494
  • Fax: 707-433-0229
Mailing address:
  • Phone: 707-385-2306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOAN CHURCHILL
Title or Position: CEO
Credential:
Phone: 707-385-2306