NPIMap

Organization Active NPI

County of Lake Public Health Department

  • Public Health or Welfare Agency
  • Clearlake, CA
National Provider Identifier
1396807459
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
COUNTY OF LAKE PUBLIC HEALTH DEPARTMENT
Practice address
7000 B South Civic Center Dr
Clearlake, CA 95422
Phone
(707) 994-9433
Fax
(707) 994-6739
NPI assigned
Dec 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Dr. Craig M McMillan, M.D.
Title
Health Officer
Phone
(707) 263-1090

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X Primary

Addresses

Primary practice location

7000 B South Civic Center Dr
Clearlake, CA 95422

Mailing address

922 Bevins CT
Lakeport, CA 95453-9754
Phone (707) 263-1090

Other identifiers 1

IdentifierTypeStateIssuer
EXE70121FMedicaidCA

National Provider Directory

National Provider Directory
Tax ID family
Lake County Health Services Department12 organizations share this tax ID, including this one

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1396807459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 BEVINS CT",
            "city": "LAKEPORT",
            "state": "CA",
            "postal_code": "954539754",
            "telephone_number": "707-263-1090",
            "fax_number": "707-262-4280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 B SOUTH CIVIC CENTER DR",
            "city": "CLEARLAKE",
            "state": "CA",
            "postal_code": "95422",
            "telephone_number": "707-994-9433",
            "fax_number": "707-994-6739"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTY OF LAKE PUBLIC HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-15",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "MCMILLAN",
        "authorized_official_first_name": "CRAIG",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "HEALTH OFFICER",
        "authorized_official_telephone_number": "707-263-1090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "EXE70121F",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Clearlake, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.