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Cdcr-pbsp
Prison Health Clinic/Center in Crescent City, California
NPI 1437280153

Cdcr-pbsp is a Prison Health Clinic/Center based in Crescent City, CA and is specialized in Prison Health. Cdcr-pbsp practices in Crescent City, CA. The NPI Number for Cdcr-pbsp is 1437280153 and holds a License No. A043460 (California).

The current practice location address for Cdcr-pbsp is 5905 Lake Earl Dr, Crescent City, CA and can be reached out via phone at 707-465-1000.

Location: 5905 Lake Earl Dr, Crescent City, CA, 95532-0001
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1437280153
Provider Name
Cdcr-pbsp
Credential
Provider Entity Type
Organization
Address
5905 Lake Earl Dr, Crescent City, CA, 95532-0001
Phone Number
707-465-1000
Fax Number
Provider Enumeration Date
03/07/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
5905 Lake Earl Dr
City
Crescent City
State
California
Zip
95532-0001
Phone Number
707-465-1000
Fax Number
person
Provider Business Mailing Address Details
Address
5905 Lake Earl Dr
City
Crescent City
State
California
Zip
95532-0001
Phone Number
707-465-1000
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Prison Health
Taxonomy
261QP2400X
License No.
A043460 (California)
Definition
Definition to come...
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