Organization
CHW MEDICAL FOUNDATION
Active
Organization
CHW MEDICAL FOUNDATION
Active
Parent organization
CHW MEDICAL FOUNDATION
Other names
Woodland Clinic, a Service of CHW Medical Foundation
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHW MEDICAL FOUNDATION
Authorized official
THERESA M HYLEN (CHIEF FINANCIAL OFFICER)
(916) 851-2559
Entity
Organization
Contact information
Practice address
239 W COURT ST, WOODLAND, CA 95695-2900
(530) 668-2656
(530) 662-4527
Mailing address
1321 COTTONWOOD ST, WOODLAND, CA 95695-5131
(530) 666-1631
(530) 666-7255
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
571205856
IRS
—
05
—
GR0013030
—
CA
05
—
GR0091674
—
CA
01
—
ZZZ52383Z
BLUE SHIELD
CA
Enumeration date
03/26/2007
Last updated
11/18/2020
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