MARK TWAIN MEDICAL CENTER (NPI# 1588725196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588725196 |
| Entity Type | Organization |
| Organization Name | MARK TWAIN MEDICAL CENTER |
| Other Organization Name | FAMILY MEDICAL CENTER - COPPEROPOLIS |
| Practice Address |
3505 Spangler Ln Suite 400 Copperopolis CA 95228-9583 |
| Mailing Address |
768 Mountain Ranch Rd San Andreas CA 95249-9707 |
| Practice Telephone | 2097857000 |
| Practice Fax Number | 2097857025 |
| Mailing Telephone | 2097857000 |
| Mailing Fax Number | 2097857025 |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2016-05-12 |
| Authorized Official Name | CHRIS ROBERTS (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 2097542614 |
| Is Organization Subpart | Y |
| Parent Organization Name | MARK TWAIN MEDICAL CENTER |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QR1300X |
Clinic/Center Specialization: Rural Health |
030000058 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | RHM08548F | 05 | |
| BLUE SHIELD OF CA | ZZZ61268Z | 01 |
| Other Name | Type Code |
|---|---|
| Family Medical Center - Copperopolis | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942362561 | Mark Twain Medical Center | Clinic/Center | 590 Stanislaus Avenue, Angels Camp, CA 95222-0000 | 2006-12-14 |
| 1255730545 | Mark Twain Medical Center | Clinic/Center | 768 Mountain Ranch Rd, San Andreas, CA 95249-9707 | 2014-08-22 |
| 1205002938 | Mark Twain Medical Center | Clinic/Center | 704 Mountain Ranch Rd, San Andreas, CA 95249-9707 | 2008-05-02 |
| 1790846301 | Mark Twain Medical Center | Clinic/Center | 2182 Highway 4, Suite A-100, Arnold, CA 95223-9908 | 2006-12-13 |
| 1821159443 | Mark Twain Medical Center | Clinic/Center | 1919 Vista Del Lago Dr, Valley Springs, CA 95252-9294 | 2006-12-13 |
| 1508968819 | Mark Twain Medical Center | General Acute Care Hospital | 768 Mountain Ranch Rd, San Andreas, CA 95249-9707 | 2006-09-05 |
| Street Address |
3505 SPANGLER LN SUITE 400 |
| City | COPPEROPOLIS |
| State | CA |
| Zip Code | 95228-9583 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487986519 | Emotional and Behavioral Helath Services | Clinic/Center | 1165 Ranch Rd, Copperopolis, CA 95228 | 2010-01-29 |
| 1760610497 | Sofia R. Bulahan | Nurse Practitioner | Copperopolis Family Medical Clinic, 3505 Spangler Lane, Suite 400, Copperopolis, CA 95228 | 2009-07-01 |
| 1093140238 | Kevin S Tom | Pharmacy | 49 Cosmic Ct Ste C, Copperopolis, CA 95228-9300 | 2013-09-06 |
| 1164529459 | Copperopolis Pharmacy | Pharmacy | 49 Cosmic Ct, Suite C, Copperopolis, CA 95228-9300 | 2006-09-20 |
| 1891975108 | Mark Scott Demanes | Marriage & Family Therapist | 120 Athena Dr, Copperopolis, CA 95228-9329 | 2007-11-05 |
| 1083636328 | Richard Wesley French | Dentist | 90 Copper Cove Dr Ste A, Copperopolis, CA 95228-9373 | 2006-07-24 |
| 1750886651 | Kirandeep Kaur Dds Inc | Clinic/Center | 90 Copper Cove Dr Ste A, Copperopolis, CA 95228-9373 | 2018-03-24 |
| 1073878021 | Kirandeep Kaur | Dentist | 90 Copper Cove Dr Ste A, Copperopolis, CA 95228-9373 | 2012-07-05 |
| 1427582725 | The Lakes At Black Creek | Substance Abuse Rehabilitation Facility | 88 Sanguinetti Ct, Copperopolis, CA 95228-9459 | 2017-04-13 |
| 1538622162 | Ocean Reid Grohman | Specialist/Technologist | 20 Vista Knolls Ct, Copperopolis, CA 95228-9475 | 2019-04-10 |
| Find all providers in zip 95228 | ||||
| Taxonomy Code | 261QR1300X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Rural Health |
| Definition to come... |
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| 1679038434 | Ridgecrest Regional Hospital | Clinic/Center | 105 E Sydnor Ave, Ridgecrest, CA 93555-5546 | 2019-02-06 |
| Find all providers with the same taxonomy | ||||
| City | COPPEROPOLIS |
| Zip Code | 95228 |
Please comment or provide details below to improve the information on MARK TWAIN MEDICAL CENTER.
| 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.