Organization
MARK TWAIN MEDICAL CENTER
Active
Parent organization
MARK TWAIN MEDICAL CENTER
Other names
Family Medical Center - Arnold
Organization subpart
Yes
Provider details
NPI number
Legal business name
MARK TWAIN MEDICAL CENTER
Authorized official
CHRIS ROBERTS (CHIEF FINANCIAL OFFICER)
(209) 754-2614
Entity
Organization
Contact information
Practice address
2182 HIGHWAY 4, SUITE A-100, ARNOLD, CA 95223-9908
(209) 795-4193
(209) 795-0828
Mailing address
768 MOUNTAIN RANCH RD, SAN ANDREAS, CA 95249-9707
(209) 795-4193
(209) 795-0828
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
030000058
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM18573F
—
CA
01
—
ZZZ61266Z
BLUE SHIELD OF CA
—
Enumeration date
12/13/2006
Last updated
05/12/2016
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