# OCCUPATIONAL HEALTH SERVICES OF MAD RIVER

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912083171
- **Authorized official:** MICHAEL J YOUNG (CFO)
- **Authorized official phone:** (707) 826-8203

## Contact information

- **Practice address:** 3800 JANES RD, SHAW MEDICAL PAVILION, ARCATA, CA 95521-4742
- **Practice address phone:** (707) 825-4907
- **Practice address fax:** (707) 825-4908
- **Mailing address:** PO BOX 4696, ARCATA, CA 95518-4696
- **Mailing address phone:** (707) 825-4907
- **Mailing address fax:** (707) 825-4908

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | CA | Yes |

## Other

- **Enumeration date:** 10/31/2006
- **Last updated:** 08/22/2020