Organization
LAKE COUNTY HEALTH SERVICES DEPARTMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN W. MOORE M.P.H. (ADMINISTRATIVE MANAGER)
(707) 263-8929
Entity
Organization
Contact information
Practice address
922 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8929
(707) 263-1662
Mailing address
922 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8929
(707) 263-1662
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
EXE70106F
—
CA
05
—
EXE70121F
—
CA
Enumeration date
07/09/2006
Last updated
08/26/2024
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