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General NPI Number Information
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NPI Number | 1104294479
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Entity Type | Organization
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Legal Business Name | COMMUNITY HEALTHCARE PARTNER, INC.
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Dates
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Enumeration Date | 09/03/2015
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Last Update Date | 09/03/2015
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Provider Practice Location Address
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Address Line | 1401 BAILEY AVENUE BUILDING A
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City | NEEDLES
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State | CA
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Zip | 92363-3103
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Country | US
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Telephone | 760-326-7160
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Fax | 760-326-7292
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Provider Business Mailing Address
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Address Line | 1401 BAILEY AVENUE BUILDING A
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City | NEEDLES
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State | CA
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Zip | 92363-3103
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Country | US
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Telephone | 760-326-7160
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Fax | 760-326-7292
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Authorized Official
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Title or Position | CEO
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Name | MR. STEVE KELLEY LOPEZ
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Credential |
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Telephone | 760-326-7160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | 240000227
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License Number State | CA
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