COVENANT HEALTH MEDICAL GROUP


Address: 10831 Combie Rd Ste D, Auburn, CA 95602-8953
Phone: 5302324646

COVENANT HEALTH MEDICAL GROUP (NPI# 1043850621) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1043850621
Entity Type Organization
Organization Name COVENANT HEALTH MEDICAL GROUP
Practice Address 10831 Combie Rd Ste D
Auburn
CA 95602-8953
Mailing Address 330 Cape Horn Rd E
Colfax
CA 95713-9434
Practice Telephone 5302324646
Mailing Telephone 5302324646
Enumeration Date 2020-01-10
Last Update Date 2020-01-10
Authorized Official Name BROOKE S JUNGI (PRACTICE OPERATIONS MANAGER)
Authorized Official Telephone 5304516234
Is Organization Subpart N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 261QP2300X Clinic/Center
Specialization: Primary Care
Ambulatory Health Care Facilities

Provider Secondary Practice Location

Address Telephone Number Fax Number
11386 Pleasant Valley Rd, Penn Valley, CA 959469000 5304516234

Office Location

Street Address 10831 COMBIE RD STE D
City AUBURN
State CA
Zip Code 95602-8953

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Taxonomy Information

Taxonomy Code 261QP2300X
Grouping Ambulatory Health Care Facilities
Classification Clinic/Center
Specialization Primary Care

Taxonomy Definition

Definition to come...

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Competitor

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City AUBURN
Zip Code 95602

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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