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Organization

COALINGA MEDICAL CENTER, LLC

Active
Other names
COALINGA REGIONAL MEDICAL CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
TAMMY JEAN THOMPSON (EXECUTIVE VP/CFO)
(209) 287-6308
Entity
Organization

Contact information

Practice address
1191 PHELPS AVE, COALINGA, CA 93210-9609
(559) 935-6562
(559) 935-6596
Mailing address
700 17TH ST STE 205, MODESTO, CA 95354-1249
(209) 287-6308
(209) 248-7825

Taxonomy

Speciality
Code
Description
License number
State
174200000X
Meals Provider
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
HSP40397F
CA
05
LTC55539F
CA
05
ZZR00397F
CA
Enumeration date
07/06/2006
Last updated
01/25/2022
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