Organization
OPEN DOOR COMMUNITY HEALTH CENTERS
Active
Organization
OPEN DOOR COMMUNITY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICTOR STARR (PRESIDENT/CEO)
(707) 826-8633
Entity
Organization
Contact information
Practice address
1275 8TH ST, ARCATA, CA 95521-5770
(707) 826-8633
(707) 826-8638
Mailing address
1275 8TH ST, ARCATA, CA 95521-5770
(707) 826-8633
(707) 826-8638
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05-1055
MEDICARE PART A
CA
01
—
05-1940
MEDICARE PART A
CA
01
—
05-1941
MEDICARE PART A
CA
01
—
05-1942
MEDICARE PART A
CA
01
—
55-1818
MEDICARE PART A
CA
01
—
55-1916
MEDICARE PART A
CA
01
—
55-1917
MEDICARE PART A
CA
05
—
FHC03890G
—
CA
05
—
FHC03892F
—
CA
05
—
FHC03919F
—
CA
05
—
FHC03920F
—
CA
05
—
FHC70779F
—
CA
05
—
FHC70869F
—
CA
05
—
FHC70970F
—
CA
05
—
FHC71103F
—
CA
01
—
ZZZ21581Z
MEDICARE PART B
CA
01
—
ZZZ27933Z
MEDICARE PART B
CA
01
—
ZZZ29825Z
MEDICARE PART B
CA
01
—
ZZZ36797Z
MEDICARE PART B
CA
01
—
ZZZ75686Z
MEDICARE PART B
CA
Enumeration date
10/25/2007
Last updated
06/07/2023
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