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AMETHYST MEDICAL GROUP INC. NPI 1194836338


NPI Information

NPI: 1194836338
Provider Name: AMETHYST MEDICAL GROUP, INC.

Doing Business As: AMETHYST MEDICAL GROUP

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 05D0954194

Address:
590 SEARLS AVE
SUITE A
NEVADA CITY, CA
ZIP 95959
Phone: (530) 798-5003
Get Directions

AMETHYST MEDICAL GROUP, INC. is a family medicine in Nevada City, CA. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. AMETHYST MEDICAL GROUP, INC. NPI is 1194836338. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Amethyst Medical Group.

The provider's business location address is:

590 SEARLS AVE
SUITE A
NEVADA CITY, CA
ZIP 95959-043
Phone: (530) 798-5003
Fax: (530) 271-2338

The provider's authorized official is Winifred Myrna Loesch .
The authorized official title is President and has the following contact phone number (530) 798-5003.

The CLIA number assigned to this NPI record is 05D0954194 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 8/31/2006 and was last updated on 8/19/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineC42292CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1A37785MEDICARE UPINCALIFORNIA
2ZZZ25085ZMEDICARE ID-TYPE UNSPECIFIEDCALIFORNIAGROUP ID
300C422920OTHERCALIFORNIAPPIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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