Organization
ARCATA COMMUNITYLIFE MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARCELLE MAHAN M.D. (PHYSICIAN ADMINISTRATOR)
(707) 822-3621
Entity
Organization
Contact information
Practice address
1318 H ST, ARCATA, CA 95521-5837
(707) 822-3621
(707) 826-8258
Mailing address
1318 H ST, ARCATA, CA 95521-5837
(707) 822-3621
(707) 826-8258
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G71860
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
CA
Enumeration date
11/01/2011
Last updated
11/01/2011
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