Arcata Communitylife Medical Center

Organization Active NPI Family Medicine Physician · Arcata, CA

NPI 1982980199 · NPPES record last updated Nov 1, 2011

Key facts

NPI
1982980199
Entity type
Organization (NPI type 2)
Primary specialty
Family Medicine Physician 207Q00000X
License
G71860 (CA)
Legal business name
ARCATA COMMUNITYLIFE MEDICAL CENTER
Practice address
1318 H St
Arcata, CA 95521-5837
Phone
(707) 822-3621
Fax
(707) 826-8258
NPI assigned
Nov 1, 2011
Organization subpart
No

Authorized official

Name
Dr. Marcelle Mahan, M.D.
Title
Physician Administrator
Phone
(707) 822-3621

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

National Provider Directory

Locations

1318 H St
Arcata, CA 95521
Phone (707) 822-3621

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Q00000X G71860 CA Yes

Addresses

Primary practice location

1318 H St
Arcata, CA 95521-5837

Mailing address

1318 H St
Arcata, CA 95521-5837
Phone (707) 822-3621

Other identifiers

IdentifierTypeStateIssuer
PENDINGMedicaidCA

Other providers in Arcata, CA

All providers in Arcata, CA · Family Medicine Physician in California

Sources for this page

Verify at the official NPI Registry.