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Organization

DOS PALOS MEMORIAL HOSPITAL, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RAY E SMITH (ADMINISTRATOR)
(209) 392-6121
Entity
Organization

Contact information

Practice address
2118 MARGUERITE ST, DOS PALOS, CA 93620-2339
(209) 392-6121
(209) 392-6881
Mailing address
2118 MARGUERITE ST, DOS PALOS, CA 93620-2339
(209) 392-6121
(209) 392-6881

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
261QR1300X
CA
314000000X
Skilled Nursing Facility
314000000X
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
LTC55311I
CA
05
RHM18598F
CA
Enumeration date
06/01/2005
Last updated
03/15/2012
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