Organization
SHINGLETOWN MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAMI FRASER (CEO)
(530) 474-3390
Entity
Organization
Contact information
Practice address
31292 ALPINE MEADOWS RD, SHINGLETOWN, CA 96088-9462
(530) 474-3390
(530) 474-4899
Mailing address
31292 ALPINE MEADOWS RD, SHINGLETOWN, CA 96088-9462
(530) 474-3390
(530) 474-4899
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
230000091
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC03870F
—
CA
01
—
ZZZ30035Z
BLUE SHIELD
CA
Enumeration date
06/22/2005
Last updated
06/22/2021
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