MEDICARE: DOWNTOWN MEDICAL CLINIC INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center	RHM53963F	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1548345416
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOWNTOWN MEDICAL CLINIC INC.

Provider Business Mailing Address
First Line	:	2505 LUCAS ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-3340
Country	:	US
Telephone Number	:	707-443-2293
Fax Number	:	707-443-1338

Provider Business Practice Location Address
First Line	:	2505 LUCAS ST
Second Line	:
City	:	EUREKA
State	:	CA
Zip	:	95501-3340
Country	:	US
Telephone Number	:	707-443-2293
Fax Number	:	707-443-1338

Authorized Official
Title or Position	:	INTERIM CLINIC MANAGER
Name	:	JULIE MAASHOFF
Credential	:
Telephone Number	:	707-443-2293

Provider Enumeration Date	:	10/26/2006
Last Update Date	:	08/22/2020

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