Organization
EASTERN PLUMAS HEALTH CARE DISTRICT
Active
Other names
EASTERN PLUMAS HEALTH CARE PORTOLA
Organization subpart
No
Provider details
NPI number
Authorized official
JERILEE NELSON CPA (CFO)
(530) 832-6578
Entity
Organization
Contact information
Practice address
480 1ST AVE, PORTOLA, CA 96122-9405
(530) 832-6600
Mailing address
500 1ST AVE, PORTOLA, CA 96122-9406
(530) 832-6600
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QR1300X
Rural Health Clinic/Center
Primary
058522
CA
261QR1300X
Rural Health Clinic/Center
230000014
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM18522F
—
CA
01
—
ZZZ30855Z
BLUE SHILED CLINIC PRO FE
CA
Enumeration date
06/27/2005
Last updated
12/21/2022
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