CAL CITY CLINIC - NPI NUMBER 1942578943

Summary

Provider Name: CAL CITY CLINIC

NPI Number: 1942578943

Clasification: Clinic/Center (261QR1300X)

Specialization: Rural Health

Address:
9300 N LOOP BLVD STE A&B
CALIFORNIA CITY, CA
ZIP 93505

Phone Number: (760) 373-1256



Detailed Information

CAL CITY CLINIC is a rural health clinic/center in California City, CA. The assigned NPI number for this provider is 1942578943 and is registered as an organization entity type.

The provider's business address is:

9300 N LOOP BLVD STE A&B
CALIFORNIA CITY, CA
ZIP 93505-269
Phone: (760) 373-1256
Fax: (760) 373-1214

The provider's authorized official is Ashmead Ali .
The authorized official title is Owner and has the following contact phone number (661) 547-3906.

The enumeration date for this NPI number is 12/5/2011 and was last updated on 1/6/2012.

Map - Location of Practice

Similar Providers

NPI Provider Name / Taxonomy
1336433051 ASHMEAD ALI
Clinic/Center (Rural Health)
1649217431 CHUNG MEDICAL CORPORATION, INC
Clinic/Center (Rural Health)
1093111601 SHARON BELL'S MASSAGE & PAIN CENTER
Clinic/Center (Rehabilitation)





Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 261QR1300X Clinic/Center Rural Health G78625 CA Yes

Other (Legacy) Identifiers

The following legacy identifiers are available for this provider:

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1 553894 MEDICARE OSCAR/CERTIFICATION CA
2 G06444 MEDICARE UPIN
3 1093898454 MEDICAID CA
4 RHM18534G MEDICAID CA

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1942578943 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 2 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Employer Identification Number EIN The Employer Identification Number (EIN), assigned by the IRS, of the provider being identified.
4 Provider Organization Name Legal Business Name CAL CITY CLINIC The name of the organization provider. If the provider is an organization, this is the legal business name.
5 Provider First Line Business Practice Location Address 9300 N LOOP BLVD STE A&B The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
6 Provider Business Practice Location Address City Name CALIFORNIA CITY The city name in the location address of the provider being identified.
7 Provider Business Practice Location Address State Name CA The State code in the location of the provider being identified.
8 Provider Business Practice Location Address Postal Code 935052269 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
9 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
10 Provider Business Practice Location Address Telephone Number 7603731256 The telephone number associated with the location address of the provider being identified.
11 Provider Business Practice Location Address Fax Number 7603731214 The fax number associated with the location address of the provider being identified.
12 Provider Enumeration Date 12/5/2011 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 1/6/2012 The date that a record was last updated or changed.
14 Authorized Official Last Name ALI The last name of the person authorized to submit the NPI application or to change NPS data for a health care provider.
15 Authorized Official First Name ASHMEAD The first name of the authorized official.
16 Authorized Official Title or Position OWNER The title or position of the authorized official.
17 Authorized Official Telephone Number 6615473906 The 10-position telephone number of the authorized official.
18 Healthcare Provider Taxonomy Code 1 261QR1300X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
19 Provider License Number 1 G78625 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
20 Provider License Number State Code 1 CA The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
21 Healthcare Provider Primary Taxonomy Switch 1 Y
22 Other Provider Identifier 1 553894 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
23 Other Provider Identifier Type Code 1 06 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
24 Other Provider Identifier State 1 CA
25 Other Provider Identifier 2 G06444 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
26 Other Provider Identifier Type Code 2 02 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
27 Other Provider Identifier 3 1093898454 Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
28 Other Provider Identifier Type Code 3 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
29 Other Provider Identifier State 3 CA
30 Other Provider Identifier 4 RHM18534G Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
31 Other Provider Identifier Type Code 4 05 Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
32 Other Provider Identifier State 4 CA
33 Is Organization Subpart N
34 Authorized Official Name Prefix Text MR.
35 Authorized Official Credential Text MD

Download Record

Download this NPI record in Text format: Export

Download this NPI record in Excel (CSV) format: Export

Download this NPI record in XML format: Export




This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.