Organization
CHAPA-DE INDIAN HEALTH PROGRAM, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIERK HAITSMA (CHIEF FINANCIAL OFFICER)
(530) 889-2841
Entity
Organization
Contact information
Practice address
11670 ATWOOD RD, AUBURN, CA 95603-9522
(530) 887-2800
(530) 887-2807
Mailing address
11670 ATWOOD RD, AUBURN, CA 95603-9522
(530) 887-2800
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
030000189
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THP12027F
—
CA
Enumeration date
03/07/2007
Last updated
01/03/2018
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