MACT HEALTH BOARD, INC. (NPI# 1467444364) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467444364 |
| Entity Type | Organization |
| Organization Name | MACT HEALTH BOARD, INC. |
| Other Organization Name | MACT MEDICAL SONORA |
| Practice Address |
13975 Mono Way Suite G, H & I Sonora CA 95370-2824 |
| Mailing Address |
Po Box 939 Angels Camp CA 95222-0939 |
| Practice Telephone | 2095339600 |
| Practice Fax Number | 2095339608 |
| Mailing Telephone | 2097546262 |
| Mailing Fax Number | 2097546274 |
| Enumeration Date | 2005-08-17 |
| Last Update Date | 2018-09-26 |
| Authorized Official Name | JOHN ALEXANDER (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 2097546258 |
| Is Organization Subpart | Y |
| Parent Organization Name | MACT HEALTH BOARD, INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
030000704 | CA | Ambulatory Health Care Facilities |
| Y | 261Q00000X | Clinic/Center | 030000704 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | THP70875F | 05 |
| Other Name | Type Code |
|---|---|
| MACT Medical Sonora | Doing Business As Name - Organization |
| Sonora Indian Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417505918 | Mact Health Board, Inc. | Dentist | 52 S Main Street, Suite B, Angels Camp, CA 95222 | 2019-08-28 |
| 1528508488 | Mact Health Board, Inc. | Optometrist | 1113a Highway 49, San Andreas, CA 95249 | 2017-02-27 |
| 1366519431 | Mact Health Board, Inc. | Clinic/Center | 1113 Highway 49, San Andreas, CA 95249 | 2006-11-30 |
| 1295727287 | Mact Health Board, Inc. | Clinic/Center | 12140/12150 New York Ranch Rd, Jackson, CA 95642-9407 | 2005-08-17 |
| 1346410255 | Mact Health Board, Inc. | Clinic/Center | 1113 Hwy 49, San Andreas, CA 95249-9583 | 2008-03-06 |
| 1740272731 | Mact Health Board, Inc. | Clinic/Center | 5192 Hospital Rd, Mariposa, CA 95338-9524 | 2005-08-17 |
| Street Address |
13975 MONO WAY SUITE G, H & I |
| City | SONORA |
| State | CA |
| Zip Code | 95370-2824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104821032 | Estevan Acuna | Registered Nurse | 13975 Mono Way, Suite G, Sonora, CA 95370-2824 | 2005-06-16 |
| 1518157346 | Richard D. Emery Dds, Inc | Dentist | 13975 Mono Way, Suite A, Sonora, CA 95370-2824 | 2007-07-27 |
| 1205039518 | H Charles Mckelvey Dds Inc | Dentist | 13975 Mono Way, Suite A, Sonora, CA 95370-2824 | 2007-06-06 |
| 1871569889 | Todd C Self | Podiatrist | 13975 Mono Way, Ste J, Sonora, CA 95370-2824 | 2006-02-28 |
| 1508848177 | Carol A Wiley | Nurse Practitioner | 13975 Mono Way, Suite G, Sonora, CA 95370-2824 | 2005-11-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174056089 | Chris Neves | Case Management | 427 N Highway 49, Suite 305, Sonora, CA 95370 | 2017-04-07 |
| 1528433885 | Michael French Dds Dental Corporation | General Acute Care Hospital | 800 Morningstar Dr, Sonora, CA 95370 | 2015-12-11 |
| 1942681465 | Amanda Evans | Registered Nurse | 20111 Cedar Rd North, Sonor, CA 95370 | 2015-06-10 |
| 1043625916 | Cicely Chen | Obstetrics & Gynecology | 900 Greenley Rd, Suite 922 Adventist Health (sierra Ob/, Sonora, CA 95370 | 2014-06-30 |
| 1457781692 | Donnie E Campbell | Homeopath | 63 South Stewart St, Sonora, CA 95370 | 2013-11-26 |
| 1386078186 | Jo Ann M Rascon | Marriage & Family Therapist | 38 N Washington St, Suite F, Sonora, CA 95370 | 2013-08-28 |
| 1831449735 | Sami Rhodes | Case Manager/Care Coordinator | 427 N. Highway 49, Sonora, CA 95370 | 2012-09-18 |
| 1619225273 | Melissa Parrish | Registered Nurse | 20111 Cedar Rd. North, Sonora, CA 95370 | 2012-08-29 |
| 1295033504 | Magdalena Martinez Bauman | Marriage & Family Therapist | 175 Fairview Ln., Sonora, CA 95370 | 2011-03-10 |
| 1588804215 | Holly Gwendolyn Harris | Physical Therapist | 15274 Camino Del Parque Rd. S, Sonora, CA 95370 | 2009-02-20 |
| Find all providers in zip 95370 | ||||
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063782183 | Kathy Bosch Chiropractic, Inc | Clinic/Center | 19515 Village Dr, Ste B, Sonora, CA 95370-9586 | 2012-01-05 |
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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.