Organization
KARUK TRIBE
Active
Other names
KARUK COMMUNITY HEALTH CLINIC
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN MARY TIRATERRA (BUSINESS OFFICE DIRECTOR)
(530) 493-1600
Entity
Organization
Contact information
Practice address
64105 HILLSIDE ROAD, HAPPY CAMP, CA 96039
(530) 493-1450
(530) 493-1451
Mailing address
PO BOX 1016, HAPPY CAMP, CA 96039-1016
(530) 493-5257
(530) 493-5270
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
CA
1223G0001X
General Practice Dentistry
—
CA
208D00000X
General Practice Physician
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1952483406
MEDICARE
CA
05
—
1952483406
—
CA
01
—
ZZZ09861Z
BLUE SHIELD OF CALIFORNIA
CA
Enumeration date
10/20/2006
Last updated
01/30/2025
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