Organization
SURPRISE VALLEY HEALTH CARE DISTRICT
Active
Other names
Surprise Valley Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
WANDA L GROVE (ADMINISTRATOR)
(530) 279-6111
Entity
Organization
Contact information
Practice address
745 MAIN STREET, CEDARVILLE, CA 96104
(530) 279-6111
(530) 279-2680
Mailing address
PO BOX 246, CEDARVILLE, CA 96104-0246
(530) 279-6111
(530) 279-2680
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
230000025
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
BCP13983F
—
CA
05
—
HAP13983F
—
CA
05
—
RHM13983F
—
CA
Enumeration date
10/17/2006
Last updated
09/11/2013
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