Provider Demographics
NPI:1659404820
Name:COLUSA REGIONAL MEDICAL CENTER
Entity Type:Organization
Organization Name:COLUSA REGIONAL MEDICAL CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAKILA
Authorized Official - Middle Name:DEVI
Authorized Official - Last Name:NARAYAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-458-5821
Mailing Address - Street 1:199 E WEBSTER ST
Mailing Address - Street 2:
Mailing Address - City:COLUSA
Mailing Address - State:CA
Mailing Address - Zip Code:95932-2954
Mailing Address - Country:US
Mailing Address - Phone:530-458-5821
Mailing Address - Fax:530-458-3230
Practice Address - Street 1:199 E WEBSTER ST
Practice Address - Street 2:
Practice Address - City:COLUSA
Practice Address - State:CA
Practice Address - Zip Code:95932-2954
Practice Address - Country:US
Practice Address - Phone:530-458-5821
Practice Address - Fax:530-458-3230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-14
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ29150ZMedicare ID - Type UnspecifiedPART B