Fort Bidwell Indian Community
NPI #1093931107 in Fort Bidwell, California
Provider Information
- NPI Number
- 1093931107
- Entity Type
- Organization
- Organization Name
- Fort Bidwell Indian Community
- Primary Specialty
- Clinic/Center - Rural Health
- Enumeration Date
- Apr 17, 2007
- Last Updated
- Jul 2, 2008
Practice Location
- Address
- 132 MEE THEE UH ROAD
- City
- Fort Bidwell
- State
- California
- ZIP Code
- 96112
- Phone
- (530) 279-6194
Authorized Official
- Name
- CANDICE DAWN RUSSELL, FNP
- Title
- CLINIC MANAGER
- Phone
- (530) 279-6194
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Rural Health — Rural Health |
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