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General NPI Number Information
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NPI Number | 1689751687
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Entity Type | Organization
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Legal Business Name | COUNTY OF HUMBOLDT
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 01/05/2010
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Provider Practice Location Address
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Address Line | 529 I STREET
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City | EUREKA
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State | CA
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Zip | 95501-1116
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Country | US
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Telephone | 707-445-6200
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Fax | 707-445-6097
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Provider Business Mailing Address
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Address Line | 529 I STREET
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City | EUREKA
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State | CA
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Zip | 95501-1116
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Country | US
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Telephone | 707-445-6200
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Fax | 707-445-6097
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Authorized Official
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Title or Position | PUBLIC HEALTH BRANCH DIRECTOR
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Name | SUSAN BUCKLEY
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Credential |
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Telephone | 707-268-2121
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | 05D0666113
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License Number State | CA
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