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Organization

SOUTHERN MONO HEALTH CARE DISTRICT

Active
Other names
Mammoth Hospital Physician Group
Organization subpart
No

Provider details

NPI number
Authorized official
MR. GARY BOYD (CHIEF EXECUTIVE OFFICER)
(760) 934-3311
Entity
Organization

Contact information

Practice address
85 SIERRA PARK ROAD, MAMMOTH LAKES, CA 93546-0660
(760) 872-6749
(760) 872-6790
Mailing address
PO BOX 660, MAMMOTH LAKES, CA 93546-0660
(760) 872-6749
(760) 872-6790

Taxonomy

Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
240000008
CA
282NR1301X
Rural Acute Care Hospital
240000008
CA

Other

Enumeration date
01/20/2010
Last updated
01/20/2010
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