NPIMap

Organization Active NPI

U.S. Coast Guard Group/Air Station Humboldt Bay Clinic

  • Clinic/Center
  • McKinleyville, CA
National Provider Identifier
1003998295
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
U.S. COAST GUARD GROUP/AIR STATION HUMBOLDT BAY CLINIC
Practice address
1001 Lycoming Ave
McKinleyville, CA 95519-9308
Phone
(707) 839-6176
NPI assigned
Oct 19, 2006
Last updated
Jul 21, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Edgardo Cabunoc Capacite
Title
Clinic Administrator
Phone
(707) 839-6176

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X DC Primary

Addresses

Primary practice location

1001 Lycoming Ave
McKinleyville, CA 95519-9308

Mailing address

1001 Lycoming Ave
McKinleyville, CA 95519-9308
Phone (707) 839-6176

National Provider Directory

National Provider Directory
Tax ID family
Uscg Isc New Orleans65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 8

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1003998295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 LYCOMING AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955199308",
            "telephone_number": "707-839-6176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 LYCOMING AVE",
            "city": "MCKINLEYVILLE",
            "state": "CA",
            "postal_code": "955199308",
            "telephone_number": "707-839-6176"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "U.S. COAST GUARD GROUP/AIR STATION HUMBOLDT BAY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "CAPACITE",
        "authorized_official_first_name": "EDGARDO",
        "authorized_official_middle_name": "CABUNOC",
        "authorized_official_title_or_position": "CLINIC ADMINISTRATOR",
        "authorized_official_telephone_number": "707-839-6176"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "DC",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McKinleyville, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.