Organization
COLUSA INDIAN HEALTH CLINIC
Active
Parent organization
COLUSA INDIAN COMMUNITY COUNCIL
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLUSA INDIAN COMMUNITY COUNCIL
Authorized official
MARK SPRAGUE (DIRECTOR OF CLINIC OPERATIONS)
(530) 458-5501
Entity
Organization
Contact information
Practice address
3710 HIGHWAY 45, COLUSA, CA 95932-4026
(530) 458-5501
(530) 458-8660
Mailing address
3710 HIGHWAY 45, COLUSA, CA 95932-4026
(530) 458-5501
(530) 458-8660
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
021859
CA
Other
Enumeration date
06/08/2012
Last updated
06/08/2012
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