Organization
COUNTY OF PLACER
Active
Organization
COUNTY OF PLACER
Active
Parent organization
PLACER COUNTY
Other names
PLACER COUNTY COMMUNITY CLINIC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PLACER COUNTY
Authorized official
MR. ROBERT LONG (CLINIC MANAGER)
(530) 886-2910
Entity
Organization
Contact information
Practice address
11583 C AVE, AUBURN, CA 95603-2703
(530) 889-7215
(530) 889-7280
Mailing address
11583 C AVE, AUBURN, CA 95603-2703
(530) 889-7215
(530) 889-7280
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
030000494
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FLU11119F
MEDICARE FLU ROSTER BILLING
CA
05
—
GR006770
—
CA
05
—
RHM53810F
—
CA
01
—
ZZZ92809Z
BLUE SHIELD
CA
Enumeration date
10/02/2006
Last updated
03/05/2014
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