Organization
CANCER DETECTION PROGRAM
Active
Other names
Mammoth Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY D. BOYD (CEO)
(760) 934-3311
Entity
Organization
Contact information
Practice address
85 SIERRA PARK ROAD, MAMMOTH LAKES, CA 93546
(760) 934-3311
(760) 924-4023
Mailing address
PO BOX 100, PMB 700, MAMMOTH LAKES, CA 93546-0100
(760) 934-3311
(760) 924-4023
Taxonomy
Speciality
Code
Description
License number
State
282NC0060X
Critical Access Hospital
Primary
240000008
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HSP40638H
CANCER DETECTION PROGRAM FOR CRITICAL ACCESS HOSPITAL
CA
Enumeration date
11/14/2008
Last updated
11/14/2008
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