Organization
NORTH COAST ENT ASSOCIATES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTIN AVILA (BILLING COORDINATOR)
(707) 822-5020
Entity
Organization
Contact information
Practice address
3770 JANES RD, ARCATA, CA 95521-4744
(707) 822-5020
(707) 822-1969
Mailing address
3770 JANES RD, ARCATA, CA 95521-4744
(707) 822-5020
(707) 822-1969
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GR0056090
MEDI-CAL
CA
Enumeration date
03/10/2006
Last updated
02/03/2009
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