# FORESTHILL MEDICAL CENTER INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Blaise deSouza MD
- **Organization subpart:** No

## Provider details

- **NPI number:** 1568410421
- **Authorized official:** DR. BLAISE PHILIP DESOUZA MD (PRESIDENT)
- **Authorized official phone:** (530) 367-2229

## Contact information

- **Practice address:** 23000 FORESTHILL RD, FORESTHILL, CA 95631
- **Practice address phone:** (530) 367-2229
- **Practice address fax:** (530) 367-4161
- **Mailing address:** PO BOX 1040, FORESTHILL, CA 95631-1040
- **Mailing address phone:** (530) 367-2229
- **Mailing address fax:** (530) 367-4161

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208D00000X | General Practice Physician | A37917 | CA | Yes |

## Other

- **Enumeration date:** 05/04/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 5362017 | — | CA |