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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