NPIMap

Organization Active NPI

Coarsegold Creek Medical Center

  • General Practice Physician
  • Coarsegold, CA
National Provider Identifier
1629646161
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
COARSEGOLD CREEK MEDICAL CENTER
Practice address
35463 Highway 41
Coarsegold, CA 93614-8722
Phone
(559) 683-6292
NPI assigned
Jun 11, 2021
Last updated
Jun 11, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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

Authorized official

Name
Dr. Stephen Dahlin, DCNPI 1407952146
Title
Owner
Phone
(559) 683-6292

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
General Practice Physician 208D00000X Primary

Addresses

Primary practice location

35463 Highway 41
Coarsegold, CA 93614-8722

Mailing address

PO Box 970
Coarsegold, CA 93614-0970
Phone (559) 683-6292

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Coarsegold

National Provider Directory

National Provider Directory

Locations

35463 Highway 41
Coarsegold, CA 93614
Phone (559) 683-6292

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1623369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623369600000",
    "number": "1629646161",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 970",
            "city": "COARSEGOLD",
            "state": "CA",
            "postal_code": "936140970",
            "telephone_number": "559-683-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35463 HIGHWAY 41",
            "city": "COARSEGOLD",
            "state": "CA",
            "postal_code": "936148722",
            "telephone_number": "559-683-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COARSEGOLD CREEK MEDICAL CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-11",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "DAHLIN",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-683-6292",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Coarsegold",
            "affiliation": "N",
            "address_1": "35463 Highway 41",
            "city": "Coarsegold",
            "state": "CA",
            "country_code": "US",
            "postal_code": "936148722",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Coarsegold, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.