Organization
HUMBOLDT RADIOLOGY MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NANCY LOUISE COBINE (BILLING MANAGER)
(707) 445-5431
Entity
Organization
Contact information
Practice address
2200 HARRISON AVE, EUREKA, CA 95501-3215
(707) 445-8121
Mailing address
PO BOX 6428, EUREKA, CA 95502-6428
(707) 445-5431
(707) 445-3710
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CN3976
RAILROAD MEDICARE
—
05
—
GR0015540
—
CA
Enumeration date
01/17/2007
Last updated
09/11/2008
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