Provider Demographics
NPI:1679115000
Name:DEL NORTE HEALTHCARE DISTRICT
Entity type:Organization
Organization Name:DEL NORTE HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATIVE ASSISTANT
Authorized Official - Prefix:
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:707-951-6704
Mailing Address - Street 1:550 E WASHINGTON BLVD STE 400
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-8161
Mailing Address - Country:US
Mailing Address - Phone:707-464-9494
Mailing Address - Fax:707-464-7845
Practice Address - Street 1:550 E WASHINGTON BLVD STE 400
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-8161
Practice Address - Country:US
Practice Address - Phone:707-464-9494
Practice Address - Fax:707-464-7845
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-17
Last Update Date:2019-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1200XAmbulatory Health Care FacilitiesClinic/CenterMagnetic Resonance Imaging (MRI)