NPIMap

Organization Active NPI

Eastern Plumas Health Care District

Doing business as Pine Street Clinic

  • Rural Health Clinic/Center
  • Portola, CA
National Provider Identifier
1073990925
Registry record updated Jul 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
License
230000014 Issued in CA
Legal business name
EASTERN PLUMAS HEALTH CARE DISTRICT
Doing business as
Pine Street Clinic
Practice address
145 N Pine St
Portola, CA 96122-8415
Phone
(530) 832-6500
NPI assigned
Apr 29, 2015
Last updated
Jul 30, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2015

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

Authorized official

Name
Thomas Hayes
Title
Ceo
Phone
(530) 832-6564

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X 230000014 CA Primary

Addresses

Primary practice location

145 N Pine St
Portola, CA 96122-8415

Mailing address

500 1St Ave
Portola, CA 96122-9406
Phone (530) 832-6500

Other names 1

  • Pine Street Clinic Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1430265600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438214400000",
    "number": "1073990925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 1ST AVE",
            "city": "PORTOLA",
            "state": "CA",
            "postal_code": "961229406",
            "telephone_number": "530-832-6500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 N PINE ST",
            "city": "PORTOLA",
            "state": "CA",
            "postal_code": "961228415",
            "telephone_number": "530-832-6500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTERN PLUMAS HEALTH CARE DISTRICT",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-29",
        "last_updated": "2015-07-30",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "530-832-6564"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "CA",
            "license": "230000014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Street Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Portola, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2015; 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.