Organization
COASTAL HEALTH ALLIANCE
Active
Organization
COASTAL HEALTH ALLIANCE
Active
Other names
Stinson Beach Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN SEVERSON (EXECUTIVE DIRECTOR)
(415) 663-8781
Entity
Organization
Contact information
Practice address
3419 STATE ROUTE ONE, STINSON BEACH, CA 94970-0978
(415) 868-9656
(415) 868-2858
Mailing address
PO BOX 910, POINT REYES STATION, CA 94956-0910
(415) 663-8781
(415) 663-9632
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
110000413
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC53833F
—
CA
Enumeration date
08/30/2006
Last updated
04/07/2008
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