Organization
MOBILE MEDICAL OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRI LYNN CLARK (EXECUTIVE DIRECTOR)
(707) 443-4666
Entity
Organization
Contact information
Practice address
1522 3RD ST, EUREKA, CA 95501-0711
(707) 443-4666
(707) 443-6123
Mailing address
PO BOX 2020, EUREKA, CA 95502-2020
(707) 443-4666
(707) 443-6123
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
110000327
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM03931G
—
CA
Enumeration date
02/20/2007
Last updated
07/29/2009
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