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General NPI Number Information
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NPI Number | 1164786869
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Entity Type | Organization
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Legal Business Name | ARETE PHYSICIANS MEDICAL GROUP, INC.
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Dates
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Enumeration Date | 06/27/2012
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Last Update Date | 12/06/2012
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Provider Practice Location Address
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Address Line | 1915 HARRISON AVE STE. A
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City | EUREKA
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State | CA
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Zip | 95501-3230
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Country | US
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Telephone | 707-497-6342
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Fax | 707-497-6234
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Provider Business Mailing Address
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Address Line | 3144 BROADWAY STE. 4-314
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City | EUREKA
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State | CA
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Zip | 95501-3838
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Country | US
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Telephone | 707-497-6342
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Fax | 707-497-6234
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Authorized Official
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Title or Position | CEO
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Name | DR. PAUL CALVIN WINDHAM
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Credential | M.D.
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Telephone | 707-497-6342
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | G057950
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License Number State | CA
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