Organization Name: | CHC |
NPI Number: | 1184028797 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MALIA JOHNSON (CLINIC DIRECTOR) |
Mailing Address: | 150 Tejas Pl Nipomo |
State: | CA US |
Postal Code: | 934449123 |
Phone Number: | 8059293254 |
Fax Number: | |
NPI Enumeration Date: | 10/11/2014 |
NPI Last Update Date: | 10/11/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 302R00000X |
License Number: | 63651 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Managed Care Organizations |
Taxonomy Classification: | Health Maintenance Organization |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |