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Enloe Medical Center

Organization Active NPI Physical Medicine & Rehabilitation Physician · Chico, CA

NPI 1972905503 · NPPES record last updated Sep 26, 2014

Key facts

NPI
1972905503
Entity type
Organization (NPI type 2)
Primary specialty
Physical Medicine & Rehabilitation Physician 208100000X
License
230000027 (CA)
Legal business name
ENLOE MEDICAL CENTER
Practice address
340 W East Ave
Chico, CA 95926-7238
Phone
(530) 332-7300
NPI assigned
Sep 26, 2014
Organization subpart
Yes
Parent organization (as reported)
ENLOE MEDICAL CENTER

Authorized official

Name
Myron Eugene Machula
Title
VP/Cfo
Phone
(530) 332-7357

Other NPIs with the same Medicare PAC ID 17

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 16

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

Practitioners 340

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 340

Medicare participation

Medicare fee-for-service enrollment
Enrolled in CA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20141027001872 CA Part B Supplier - Hospital Department(S) 9739092388 Receives reassigned benefits from 17 practitioners
Practice locations: Chico, CA

National Provider Directory

Tax ID family
Enloe General Colorectal S (17 organizations share this tax ID)
Part of
Enloe General Colorectal S

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician
Group: 193400000X SINGLE SPECIALTY GROUP		 208100000X 230000027 CA Yes

Addresses

Primary practice location

340 W East Ave
Chico, CA 95926-7238

Mailing address

1531 Esplanade
Attn: Finance
Chico, CA 95926-3310
Phone (530) 332-7479

Other names

  • Enloe Physical Medicine and Rehabilitation Clinic Doing business as

Other providers in Chico, CA

All providers in Chico, CA · Physical Medicine & Rehabilitation Physician in California

Sources for this page

Verify at the official NPI Registry.