NPIMap

Organization Active NPI

Placer County Community Clinic

  • Public Health or Welfare Agency
  • Kings Beach, CA
National Provider Identifier
1952526444
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
Legal business name
PLACER COUNTY COMMUNITY CLINIC
Practice address
8665 Salmon Ave
Kings Beach, CA 96143-9800
Phone
(530) 546-1970
Fax
(530) 546-4606
NPI assigned
Apr 17, 2007
Last updated
Jun 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Authorized official

Name
Mr. Robert Long
Title
Clinic Manager
Phone
(530) 886-2910

Specialties & licenses 1

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

Addresses

Primary practice location

8665 Salmon Ave
Kings Beach, CA 96143-9800

Mailing address

PO Box 1785
Kings Beach, CA 96143-1785
Phone (530) 546-1970

Other identifiers 1

IdentifierTypeStateIssuer
G9260102MedicaidCA

Other names 1

  • PLACER DENTAL CLINIC TAHOE Other name

National Provider Directory

National Provider Directory
Tax ID family
Placer Medical Clinic23 organizations share this tax ID, including this one

Other organizations with this tax ID 22

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

View all 22

NPI Registry JSON

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

{
    "created_epoch": "1176768000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212624000000",
    "number": "1952526444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1785",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "961431785",
            "telephone_number": "530-546-1970",
            "fax_number": "530-546-4606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8665 SALMON AVE",
            "city": "KINGS BEACH",
            "state": "CA",
            "postal_code": "961439800",
            "telephone_number": "530-546-1970",
            "fax_number": "530-546-4606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLACER COUNTY COMMUNITY CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-17",
        "last_updated": "2008-06-05",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "CLINIC MANAGER",
        "authorized_official_telephone_number": "530-886-2910",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G9260102",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PLACER DENTAL CLINIC TAHOE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kings Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.