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General NPI Number Information
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NPI Number | 1548345416
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Entity Type | Organization
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Legal Business Name | DOWNTOWN MEDICAL CLINIC INC.
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2505 LUCAS ST
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City | EUREKA
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State | CA
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Zip | 95501-3340
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Country | US
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Telephone | 707-443-2293
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Fax | 707-443-1338
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Provider Business Mailing Address
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Address Line | 2505 LUCAS ST
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City | EUREKA
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State | CA
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Zip | 95501-3340
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Country | US
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Telephone | 707-443-2293
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Fax | 707-443-1338
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Authorized Official
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Title or Position | INTERIM CLINIC MANAGER
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Name | JULIE MAASHOFF
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Credential |
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Telephone | 707-443-2293
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | RHM53963F
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License Number State | CA
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