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General NPI Number Information
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NPI Number | 1124286885
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Entity Type | Organization
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Legal Business Name | TUOLUMNE ME-WUK INDIAN HEALTH CENTER, INC.
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Dates
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Enumeration Date | 05/29/2008
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Last Update Date | 11/21/2025
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Provider Practice Location Address
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Address Line | 19969 GREENLEY RD SUITE B,C, & D
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City | SONORA
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State | CA
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Zip | 95370-5908
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Country | US
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Telephone | 209-532-0028
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Fax | 209-532-0031
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Provider Business Mailing Address
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Address Line | 18880 CHERRY VALLEY BLVD
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City | TUOLUMNE
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State | CA
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Zip | 95379-9506
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Country | US
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Telephone | 209-928-5400
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Fax | 209-928-5414
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Authorized Official
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Title or Position | CHIEF ADMINISTRATIVE OFFICE
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Name | BECKY SHOKRAII
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Credential |
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Telephone | 209-459-7933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 550000723
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License Number State | CA
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