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General NPI Number Information
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NPI Number | 1144313024
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Entity Type | Organization
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Legal Business Name | COUNTY OF PLACER
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 03/05/2014
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Provider Practice Location Address
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Address Line | 11583 C AVE
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City | AUBURN
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State | CA
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Zip | 95603-2703
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Country | US
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Telephone | 530-889-7215
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Fax | 530-889-7280
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Provider Business Mailing Address
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Address Line | 11583 C AVE
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City | AUBURN
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State | CA
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Zip | 95603-2703
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Country | US
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Telephone | 530-889-7215
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Fax | 530-889-7280
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Authorized Official
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Title or Position | CLINIC MANAGER
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Name | MR. ROBERT LONG
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Credential |
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Telephone | 530-886-2910
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 030000494
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License Number State | CA
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