NPI Code Detail JSON Logo

1215476734 NPI number — COLUSA MEDICAL CENTER LLC

NPI Number: 1215476734
Health Care Provider/Practitioner: COLUSA MEDICAL CENTER LLC

Information about “1215476734” NPI (COLUSA MEDICAL CENTER LLC) exists in 1215476734 in HTML format HTML  |  1215476734 in plain Text format TXT  |  1215476734 in PDF (Portable Document Format) PDF  |  1215476734 in an XML format XML  formats.

NPI Number : 1215476734 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1215476734",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "COLUSA MEDICAL CENTER LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": "6",
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "700 17TH ST STE 201D",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MODESTO",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "95354-1249",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "530-458-1808",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "199 E WEBSTER ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "COLUSA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "95932-2954",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "530-458-1808",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/16/2017",
    "LastUpdateDate": "01/25/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "THOMPSON",
    "AuthorizedOfficialFirstName": "TAMMY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "VP FINANCE/CFO",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "209-287-6308",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "314000000X",
        "TaxonomyName": "Skilled Nursing Facility",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.