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Organization
KARUK TRIBE
Active
Organization
KARUK TRIBE
Active
Other names
KARUK COMMUNITY HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN MARY TIRATERRA (BUSINESS OFFICE DIRECTOR)
(530) 493-1600
Entity
Organization
Contact information
Practice address
64105 HILLSIDE ROAD, HAPPY CAMP, CA 96039
(530) 493-1450
(530) 493-1451
Mailing address
PO BOX 1016, HAPPY CAMP, CA 96039-1016
(530) 493-5257
(530) 493-5270
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
CA
1223G0001X
General Practice Dentistry
—
CA
208D00000X
General Practice Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952483406
MEDICARE
CA
05
—
1952483406
—
CA
01
—
ZZZ09861Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
10/20/2006
Last updated
01/30/2025
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