HAZEL HAWKINS MEMORIAL HOSPITAL NPI 1891811907

NPI Information

NPI: 1891811907
Provider Name: HAZEL HAWKINS MEMORIAL HOSPITAL

Doing Business As: HAZEL HAWKINS HEALTH CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
301 THE ALAMEDA
SUITE B3
SAN JUAN BAUTISTA, CA
ZIP 95045
Phone: (831) 623-4615
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HAZEL HAWKINS MEMORIAL HOSPITAL is a rural health clinic center in San Juan Bautista, CA. HAZEL HAWKINS MEMORIAL HOSPITAL NPI is 1891811907. The provider is registered as an organization entity type.
The provider Is Doing Business As Hazel Hawkins Health Clinic.

The provider's business location address is:

301 THE ALAMEDA
SUITE B3
SAN JUAN BAUTISTA, CA
ZIP 95045-746
Phone: (831) 623-4615
Fax: (831) 623-4689

The provider's authorized official is Mary Casillas .
The authorized official title is Ceo and has the following contact phone number (831) 636-2604.

The CLIA number assigned to this NPI record is 05D1025239 - other - hospital based office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/21/2007 and was last updated on 1/11/2024.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QR1300X	Clinic/Center	Rural Health	070000004	CALIFORNIA	Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	RHM08590F	MEDICAID	CALIFORNIA

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: 5/5/2024

NPI Synchronization or Removal

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