Capital Region Medical Center

Organization Active NPI Family Medicine Physician · California, MO

NPI 1730151143 · NPPES record last updated Aug 23, 2013

Key facts

NPI
1730151143
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
Legal business name
CAPITAL REGION MEDICAL CENTER
Practice address
704 Buchanan Hwy SW
California, MO 65018
Phone
(573) 796-3111
Fax
(573) 796-3042
NPI assigned
Feb 2, 2006
Organization subpart
No

Authorized official

Name
Tom Luebbering
Title
VP of Finance
Phone
(573) 632-5100

Corporate family (same tax ID) 46

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

View all 46

National Provider Directory

Tax ID family
Capital Region Medical Center (47 organizations share this tax ID)

Locations

704 W Buchanan St
California, MO 65018
Phone (573) 796-3111

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X Yes

Addresses

Primary practice location

704 Buchanan Hwy SW
California, MO 65018

Mailing address

704 Buchanan Hwy SW
California, MO 65018
Phone (573) 796-3111

Other identifiers

IdentifierTypeStateIssuer
CK5622OtherMORR MEDICARE
507984300MedicaidMO

Other names

  • Capital Region Physicians - California Doing business as

Other providers in California, MO

All providers in California, MO · Family Medicine Physician in Missouri

Sources for this page

Verify at the official NPI Registry.