Provider Demographics
NPI:1184662652
Name:JOHN C FREMONT HEALTHCARE DISTRICT
Entity Type:Organization
Organization Name:JOHN C FREMONT HEALTHCARE DISTRICT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:G
Authorized Official - Last Name:MACPHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-966-3631
Mailing Address - Street 1:PO BOX 216
Mailing Address - Street 2:
Mailing Address - City:MARIPOSA
Mailing Address - State:CA
Mailing Address - Zip Code:95338-0216
Mailing Address - Country:US
Mailing Address - Phone:209-966-3631
Mailing Address - Fax:209-966-3776
Practice Address - Street 1:5189 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:MARIPOSA
Practice Address - State:CA
Practice Address - Zip Code:95338-9524
Practice Address - Country:US
Practice Address - Phone:209-966-3631
Practice Address - Fax:209-966-3776
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-04
Last Update Date:2014-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA040000108282NC0060X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NC0060XHospitalsGeneral Acute Care HospitalCritical Access
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA051304Medicare Oscar/Certification