| Organization Name: | MENDOCINO COAST CLINIC INC |
| NPI Number: | 1083783757 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PAULA COHEN (EXECUTIVE DIRECTOR) |
| Mailing Address: | 205 South Street Fort Bragg |
| State: | CA US |
| Postal Code: | 954375540 |
| Phone Number: | 7079641251 |
| Fax Number: | 7079612722 |
| NPI Enumeration Date: | 11/07/2006 |
| NPI Last Update Date: | 10/08/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QC1500X |
| License Number: | 110000179 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Community Health |
| Taxonomy Definition: | |