County of Alpine
Organization Active NPI Public Health & General Preventive Medicine Physician · Markleeville, CA
NPI 1801070909 · NPPES record last updated May 26, 2021
Key facts
- NPI
- 1801070909
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Public Health & General Preventive Medicine Physician 2083P0901X
- Legal business name
- COUNTY OF ALPINE
- Practice address
- 75 Diamond Valley Rd
Unit B
Markleeville, CA 96120-9512 - Phone
- (530) 694-2146
- Fax
- (530) 694-2770
- NPI assigned
- Dec 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Richard O Johnson, M.D.
- Title
- MPH - Public Health Officer
- Phone
- (530) 694-2146
Corporate family (same tax ID) 10
Practitioners 4
-
Patience Wenck, FNP
-
Richard A. Harvey, M.D.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050421000905 | CA | Part B Supplier - Clinic/Group Practice | 9234177007 |
Receives reassigned benefits from 3 practitioners Practice locations: Markleeville, CA |
National Provider Directory
- Tax ID family
- Alpine County
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Public Health & General Preventive Medicine Physician |
2083P0901X | Yes |
Addresses
Primary practice location
75 Diamond Valley Rd
Unit B
Markleeville, CA 96120-9512
Mailing address
75 Diamond Valley Road
Unit B
Markleeville, CA 96120-9579
Phone (530) 694-2146
Other providers in Markleeville, CA
- Alpine Midwifery, Inc.
- Nadia Jacqueline Baratti
- Amy D Broadhurst
- Gilda Elizabeth Chibante
- Community Birth Group
- Misty Dawn Dee
- Mikella Mae Doane
- Edge Medical Services
- Enki Health & Research Systems, Inc.
- Katilyn Forster
All providers in Markleeville, CA · Public Health & General Preventive Medicine Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 26, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.