HUMBOLDT MEDICAL GROUP, INC (NPI# 1265553143) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1265553143 |
| Entity Type | Organization |
| Organization Name | HUMBOLDT MEDICAL GROUP, INC |
| Practice Address |
528 Washington Street Ferndale CA 95536 |
| Mailing Address |
528 Washington St Ferndale CA 95536 |
| Practice Telephone | 7077864028 |
| Practice Fax Number | 7077869029 |
| Mailing Telephone | 7077864028 |
| Mailing Fax Number | 7077869029 |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2010-10-07 |
| Authorized Official Name | MRS. CARI ELIZABETH CANNON (ADMINISTRATOR) |
| Authorized Official Telephone | 7075994104 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | ========= | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RHM053945F | 05 |
| Street Address |
528 WASHINGTON STREET |
| City | FERNDALE |
| State | CA |
| Zip Code | 95536 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356991194 | Jacklyn Ruth Perlenfein | Technician | 1148 Main Street, Ferndale, CA 95536 | 2019-09-13 |
| 1194171330 | Stuart Altschuler | Marriage & Family Therapist | 483 A St., Ferndale, CA 95536 | 2016-05-06 |
| 1669909271 | Robbin Lynn Samuelson | Registered Nurse | 638 Main Street, Ferndale, CA 95536 | 2017-05-12 |
| 1346624533 | Christine Ross | Registered Nurse | 638 Main Street, Ferndale, CA 95536 | 2015-07-17 |
| 1174907836 | Rebecca Brennan | Registered Nurse | 638 Main Street, Ferndale, CA 95536 | 2015-07-13 |
| 1568857654 | Shawna Owsley | Registered Nurse | 638 Main Street, Ferndale, CA 95536 | 2015-04-06 |
| 1598178915 | Open Door Community Health Centers | Obstetrics & Gynecology | 638 Main Street, Ferndale, CA 95536 | 2014-06-03 |
| 1194885129 | Rings Pharmacy | Durable Medical Equipment & Medical Supplies | 362 Main St, Ferndale, CA 95536-0577 | 2006-12-11 |
| 1285854604 | Lawrence Adrian Denning | Dentist | 460 Ocean Avenue, Ferndale, CA 95536-0700 | 2007-04-26 |
| 1285601120 | Christopher Rigney Cabrera | Optometrist | 455 Ocean Avenue, Ferndale, CA 95536-0881 | 2006-02-28 |
| Find all providers in zip 95536 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679114805 | Phyllis Adolphus Nelson | Family Medicine | 362 E Troy St Uppr, Ferndale, MI 48220-2851 | 2019-09-29 |
| 1962704239 | Jacklyn Price | Family Medicine | 725 E 9 Mile Rd, Ferndale, MI 48220-1965 | 2010-11-18 |
| 1942440052 | Samuel G Browning | Family Medicine | 5616 3rd Ave., Ferndale, WA 98248 | 2009-03-02 |
| 1457417420 | Thomas J Chwierut | Family Medicine | 641 W 9 Mile Rd Ste B, Ferndale, MI 48220-1779 | 2006-12-27 |
| 1356409973 | Gurudarshan S Khalsa | Family Medicine | 484 Academy St, Ferndale, MI 48220-2821 | 2006-12-05 |
| 1225071830 | Bertha H Safford | Family Medicine | 5580 Nordic Way, Ferndale, WA 98248 | 2006-06-13 |
| 1104815232 | Robert C Levine | Family Medicine | 911 E 9 Mile Rd, Ferndale, MI 48220-1934 | 2005-10-20 |
| 1952396103 | Tamara Smith Dennis | Family Medicine | 638 Main Street, Ferndale, CA 95536-1157 | 2005-09-14 |
| 1457761322 | Walter Kalani Snyder | Family Medicine | 5580 Nordic Pl, Ferndale, WA 98248-9138 | 2014-05-01 |
| 1710241856 | Anna Marie Farhat | Family Medicine | 911 E 9 Mile Rd, Ferndale, MI 48220-1934 | 2012-07-03 |
| Find all providers in FERNDALE | ||||
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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.