Organization
SOUTHERN INDIAN HEALTH COUNCIL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERRANCE A KING (CFO)
(619) 445-1188
Entity
Organization
Contact information
Practice address
36350 CHURCH ROAD, CAMPO, CA 91906-2715
(619) 445-1188
(619) 659-3140
Mailing address
4058 WILLOWS ROAD, ALPINE, CA 91901-1668
(619) 445-1188
(619) 659-3138
Taxonomy
Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THP80243F
—
CA
Enumeration date
08/17/2005
Last updated
11/12/2024
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