Organization
HAZEL HAWKINS MEMORIAL HOSPITAL
Active
Other names
HAZEL HAWKINS HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARY CASILLAS (CEO)
(831) 636-2604
Entity
Organization
Contact information
Practice address
301 THE ALAMEDA, SUITE B3, SAN JUAN BAUTISTA, CA 95045-9746
(831) 623-4615
(831) 623-4689
Mailing address
911 SUNSET DR, HOLLISTER, CA 95023-5602
(831) 637-5711
(831) 637-3126
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
070000004
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM08590F
—
CA
Enumeration date
03/21/2007
Last updated
01/11/2024
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