Organization
MARK TWAIN MEDICAL CENTER
Active
Parent organization
MARK TWAIN MEDICAL CENTER
Other names
Family Medical Center - Copperopolis
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARK TWAIN MEDICAL CENTER
Authorized official
NIKKI OCHOA (CHIEF FINANCIAL OFFICER)
(209) 467-6442
Entity
Organization
Contact information
Practice address
430 SAWMILL CREEK RD, COPPEROPOLIS, CA 95228
(209) 785-0000
(209) 785-7085
Mailing address
768 MOUNTAIN RANCH RD, SAN ANDREAS, CA 95249-9707
(209) 785-7000
(209) 785-7025
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
030000058
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
=========
WPS TRICARE
—
05
—
RHM08548F
—
CA
01
—
ZZZ61268Z
BLUE SHIELD OF CA
—
Enumeration date
12/13/2006
Last updated
08/24/2021
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