Provider Demographics
NPI:1396705067
Name:EASTERN PLUMAS HEALTH CARE
Entity type:Organization
Organization Name:EASTERN PLUMAS HEALTH CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL STAFF COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:PEELER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:530-993-4184
Mailing Address - Street 1:500 1ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTOLA
Mailing Address - State:CA
Mailing Address - Zip Code:96122-9406
Mailing Address - Country:US
Mailing Address - Phone:530-993-4184
Mailing Address - Fax:
Practice Address - Street 1:500 1ST AVE
Practice Address - Street 2:
Practice Address - City:PORTOLA
Practice Address - State:CA
Practice Address - Zip Code:96122-9406
Practice Address - Country:US
Practice Address - Phone:530-993-4184
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG36497282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA46705Medicare UPIN