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Organization
EUREKA FAMILY PRACTICE
Active
Organization
EUREKA FAMILY PRACTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LORRAINE GOMES (MANAGER)
(707) 407-4591
Entity
Organization
Contact information
Practice address
3798 JANES RD, ARCATA, CA 95521-4753
(707) 443-8335
Mailing address
2675 HARRIS ST, EUREKA, CA 95503-4806
(707) 443-8335
(707) 443-7327
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ84055Z
MEDICARE PROVIDER NUMBER
CA
Enumeration date
11/12/2014
Last updated
11/12/2014
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