DOS PALOS MEMORIAL HOSPITAL, INC (NPI# 1295737401) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295737401 |
| Entity Type | Organization |
| Organization Name | DOS PALOS MEMORIAL HOSPITAL, INC |
| Practice Address |
2118 Marguerite St Dos Palos CA 93620-2339 |
| Practice Telephone | 2093926121 |
| Practice Fax Number | 2093926881 |
| Mailing Telephone | 2093926121 |
| Mailing Fax Number | 2093926881 |
| Enumeration Date | 2005-06-01 |
| Last Update Date | 2012-03-15 |
| Authorized Official Name | MR. RAY E SMITH (ADMINISTRATOR) |
| Authorized Official Telephone | 2093926121 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 314000000X | Skilled Nursing Facility | 314000000X | CA | Nursing & Custodial Care Facilities |
| Y | 261Q00000X | Clinic/Center | 261QR1300X | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | LTC55311I | 05 | |
| CA | RHM18598F | 05 |
| Street Address |
2118 MARGUERITE ST |
| City | DOS PALOS |
| State | CA |
| Zip Code | 93620-2339 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417947433 | Alice Ruth Foster-smith | Nurse Practitioner | 2118 Marguerite St, Dos Palos, CA 93620-2339 | 2005-10-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215467824 | Simone Marie Goncalves | Counselor | 15728 Arroya Ave, Dos Palos, CA 93620 | 2017-06-15 |
| 1962681023 | Quantom Leap | Case Manager/Care Coordinator | 22368 S. 6th, South Dos Palos, CA 93620 | 2007-10-25 |
| 1205819836 | George I Conklin | Physician Assistant | 1405 California Ave, Dos Palos, CA 93620-2300 | 2005-11-29 |
| 1265969935 | Andrea Lesa Velasquez | Registered Nurse | 1405 California Ave, Dos Palos, CA 93620-2300 | 2017-05-12 |
| 1922460914 | Diana Huizar | Nurse Practitioner | 1405 California Ave, Dos Palos, CA 93620-2300 | 2016-03-28 |
| 1891073425 | Shannon Nicol Clasen | Nurse Practitioner | 1405 California Ave, Dos Palos, CA 93620-2300 | 2011-08-01 |
| 1952521759 | Golden Valley Health Centers | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| 1861612665 | Golden Valley Health Centers | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| 1770703571 | Golden Valley Health Center | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| 1689894487 | Golden Valley Health Centers | Family Medicine | 1405 California Ave, Dos Palos, CA 93620-2300 | 2007-04-26 |
| Find all providers in zip 93620 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 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.