Provider Demographics
NPI:1619070729
Name:FEATHER DOWN FAMILY PRACTICE ASSOCIATES, A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:FEATHER DOWN FAMILY PRACTICE ASSOCIATES, A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:E
Authorized Official - Last Name:BUCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-751-1800
Mailing Address - Street 1:1590 POOLE BLVD
Mailing Address - Street 2:
Mailing Address - City:YUBA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95993-2607
Mailing Address - Country:US
Mailing Address - Phone:530-751-1800
Mailing Address - Fax:
Practice Address - Street 1:1590 POOLE BLVD
Practice Address - Street 2:
Practice Address - City:YUBA CITY
Practice Address - State:CA
Practice Address - Zip Code:95993-2607
Practice Address - Country:US
Practice Address - Phone:530-751-1800
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR0090230Medicaid
CAZZZ21104ZMedicare ID - Type Unspecified