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Organization
NORTH PACIFIC CARDIOLOGY MEDICAL
Active
Organization
NORTH PACIFIC CARDIOLOGY MEDICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS ALLEN SHAW (CHIEF EXECUTIVE OFFICER)
(707) 822-7220
Entity
Organization
Contact information
Practice address
3800 JANES RD, ARCATA, CA 95521-4742
(707) 822-3621
Mailing address
PO BOX 306, ARCATA, CA 95518-0306
(707) 822-7250
(707) 826-8258
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093821837
MEDI-CAL
CA
05
—
1093821837
—
CA
Enumeration date
08/22/2006
Last updated
07/21/2022
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