Calaveras Emergency Physicians,

Organization Active NPI Emergency Medicine Physician · San Andreas, CA

NPI 1003109570 · NPPES record last updated Feb 10, 2014

Key facts

NPI
1003109570
Entity type
Organization (NPI type 2)
Primary specialty
Emergency Medicine Physician 207P00000X
Legal business name
CALAVERAS EMERGENCY PHYSICIANS,
Practice address
768 Mountain Ranch Rd
San Andreas, CA 95249-9707
Phone
(209) 754-3251
NPI assigned
May 17, 2011
Organization subpart
No

Authorized official

Name
Charles T Mitchell, MD
Title
President
Phone
(469) 401-2386

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician
Group: 193200000X MULTI-SPECIALTY GROUP
207P00000X Yes
Physician Assistant
Group: 193200000X MULTI-SPECIALTY GROUP
363A00000X
Nurse Practitioner
Group: 193200000X MULTI-SPECIALTY GROUP
363L00000X

Addresses

Primary practice location

768 Mountain Ranch Rd
San Andreas, CA 95249-9707

Mailing address

13737 Noel Rd
Ste 1600
Dallas, TX 75240-1331
Phone (469) 401-2386

Other providers in San Andreas, CA

All providers in San Andreas, CA · Emergency Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.