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Organization
KIDNEY CARE SERVICES OF HUMBOLDT
Active
Organization
KIDNEY CARE SERVICES OF HUMBOLDT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES LEE WYNN JR. (ADMIN AIDE)
(707) 599-6700
Entity
Organization
Contact information
Practice address
1651 MYRTLE AVE STE C, EUREKA, CA 95501-1495
(707) 599-6700
(888) 475-8698
Mailing address
1651 MYRTLE AVE STE C, EUREKA, CA 95501-1495
(707) 599-6700
(888) 475-8698
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
23313
CA
261QH0100X
Health Service Clinic/Center
—
—
261QP2300X
Primary Care Clinic/Center
—
—
332900000X
Non-Pharmacy Dispensing Site
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RN846580
—
CA
Enumeration date
07/04/2015
Last updated
06/04/2026
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