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General NPI Number Information
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NPI Number | 1770756736
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Entity Type | Organization
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Legal Business Name | FREMONT-RIDEOUT HEALTH GROUP
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 840 WASHINGTON AVE
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City | YUBA CITY
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State | CA
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Zip | 95991-2833
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Country | US
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Telephone | 530-790-3075
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Fax | 530-790-3071
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Provider Business Mailing Address
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Address Line | 840 WASHINGTON AVE
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City | YUBA CITY
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State | CA
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Zip | 95991-2833
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Country | US
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Telephone | 530-790-3075
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Fax | 530-790-3071
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Authorized Official
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Title or Position | VP SENIOR SERVICES
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Name | MR. CHRIS PARKER
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Credential |
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Telephone | 530-790-3000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 311500000X
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Taxonomy Name | Alzheimer Center (Dementia Center)
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License Number |
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License Number State | CA
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