HUMBOLDT RADIOLOGY MEDICAL GROUP INC (NPI# 1073665055) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073665055 |
| Entity Type | Organization |
| Organization Name | HUMBOLDT RADIOLOGY MEDICAL GROUP INC |
| Practice Address |
850 Highway 96 Willow Creek CA 95573 |
| Mailing Address |
Po Box 6428 Eureka CA 95502-6428 |
| Practice Telephone | 5306293116 |
| Mailing Telephone | 7074455431 |
| Mailing Fax Number | 7074453710 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MRS. NANCY LOUISE COBINE (BILLING MANAGER) |
| Authorized Official Telephone | 7074455431 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942709803 | Humboldt Radiology Medical Group Inc | Radiology | 3300 Renner Dr, Fortuna, CA 95540-3120 | 2018-02-06 |
| 1538211719 | Humboldt Radiology Medical Group Inc | Radiology | 2675 Harris St, Eureka, CA 95503-4806 | 2007-01-17 |
| 1841342128 | Humboldt Radiology Medical Group Inc | Radiology | 733 Cedar St, Garberville, CA 95542-3201 | 2007-01-17 |
| 1972655058 | Humboldt Radiology Medical Group Inc | Radiology | 2200 Harrison Ave, Eureka, CA 95501-3215 | 2007-01-17 |
| 1326154196 | Humboldt Radiology Medical Group Inc | Radiology | 2330 Buhne St, Eureka, CA 95501 | 2006-08-22 |
| Street Address |
850 HIGHWAY 96 |
| City | WILLOW CREEK |
| State | CA |
| Zip Code | 95573 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275007601 | Shannon M Bates | Counselor | 38883 Ca-299, Willow Creek, CA 95573 | 2019-01-18 |
| 1508115841 | Aileen Burns | Registered Nurse | 3883 Hwy 299, Willow Creek, CA 95573 | 2012-08-31 |
| 1194025890 | Humboldt County Behavioral Health | Community/Behavioral Health | 77 Walnut Way, Willow Creek, CA 95573 | 2010-10-27 |
| 1033363403 | Roland N Grubb | Dentist | 40618 Hwy 299, Willow Creek, CA 95573 | 2008-11-11 |
| 1235338096 | Loretta Rae Mccurtain | Nurse Practitioner | Highway 96, Willow Creek, CA 95573 | 2007-07-12 |
| 1376570473 | Willow Creek - Six Rivers Medical Center | Clinic/Center | 850 State Hwy 96, Willow Creek, CA 95573 | 2006-06-26 |
| 1952367864 | William O. Jones | Physician Assistant | 38883 Hwy 299, Willow Creek, CA 95573 | 2006-04-21 |
| 1447590385 | Lanesha Bracy | Nurse Practitioner | 38883 Hwy 299, Willow Creek, CA 95573 | 2013-02-28 |
| 1063743730 | Patricia Komlenic | Registered Nurse | 38883 Highway 299, Willow Creek, CA 95573 | 2010-01-20 |
| 1861720229 | Cynthia Llewellyn | Registered Nurse | 38883 Highway 299, Willow Creek, CA 95573 | 2009-11-24 |
| Find all providers in zip 95573 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
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| Find all providers with the same taxonomy | ||||
| City | WILLOW CREEK |
| Zip Code | 95573 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.