NPIMap

Organization Active NPI

Cancer Detection Program

Doing business as Mammoth Hospital

  • Critical Access Hospital
  • Mammoth Lakes, CA
National Provider Identifier
1710131867
Registry record updated Nov 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
240000008 Issued in CA
Legal business name
CANCER DETECTION PROGRAM
Doing business as
Mammoth Hospital
Practice address
85 Sierra Park Road
Mammoth Lakes, CA 93546
Phone
(760) 934-3311
Fax
(760) 924-4023
NPI assigned
Nov 14, 2008
Last updated
Nov 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2008

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

Authorized official

Name
Mr. Gary D. Boyd
Title
Ceo
Phone
(760) 934-3311

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X 240000008 CA Primary

Addresses

Primary practice location

85 Sierra Park Road
Mammoth Lakes, CA 93546

Mailing address

PO Box 100
PMB 700
Mammoth Lakes, CA 93546-0100
Phone (760) 934-3311

Other identifiers 1

IdentifierTypeStateIssuer
HSP40638HOtherCACANCER DETECTION PROGRAM FOR CRITICAL ACCESS HOSPITAL

Other names 1

  • Mammoth Hospital Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Mammoth Hospitalb Crai9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

NPI Registry JSON

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

{
    "created_epoch": "1226620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1226620800000",
    "number": "1710131867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100",
            "address_2": "PMB 700",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "935460100",
            "telephone_number": "760-934-3311",
            "fax_number": "760-924-4023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "85 SIERRA PARK ROAD",
            "city": "MAMMOTH LAKES",
            "state": "CA",
            "postal_code": "93546",
            "telephone_number": "760-934-3311",
            "fax_number": "760-924-4023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CANCER DETECTION PROGRAM",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-14",
        "last_updated": "2008-11-14",
        "status": "A",
        "authorized_official_last_name": "BOYD",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "760-934-3311",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "CA",
            "license": "240000008",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CANCER DETECTION PROGRAM FOR CRITICAL ACCESS HOSPITAL",
            "identifier": "HSP40638H",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mammoth Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Mammoth Lakes, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2008; 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.