MARK TWAIN MEDICAL CENTER NPI 1942362561

NPI Information

MARK TWAIN MEDICAL CENTER is a rural health clinic center in Angels Camp, CA. MARK TWAIN MEDICAL CENTER NPI is 1942362561. The provider is registered as an organization entity type.
The provider Is Doing Business As Family Medical Center - Angels Camp.

The provider's business location address is:

590 STANISLAUS AVENUE
ANGELS CAMP, CA
ZIP 95222-000
Phone: (209) 736-0813
Fax: (209) 736-9088

The provider's authorized official is Chris Roberts .
The authorized official title is Chief Financial Officer and has the following contact phone number (209) 754-2614.

The CLIA number assigned to this NPI record is 05D0963207 - rural health clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/14/2006 and was last updated on 6/9/2020.

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:

Other Identifiers

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

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