| Eastern Plumas Health Care District | |
| 
					480 1st Ave Portola CA 96122-9405  | |
| (530) 832-6500 | |
| (530) 832-1105 | 
| Full Name | Eastern Plumas Health Care District | 
|---|---|
| Speciality | General Acute Care Hospital | 
| Location | 480 1st Ave, Portola, California | 
| Authorized Official Name and Position | Jerilee Nelson (CFO) | 
| Authorized Official Contact | 5308326577 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Eastern Plumas Health Care District 500 1st Ave Portola CA 96122-9406 Ph: (530) 832-6500  | Eastern Plumas Health Care District 480 1st Ave Portola CA 96122-9405 Ph: (530) 832-6500  | 
| NPI Number | 1245236850 | 
|---|---|
| Provider Enumeration Date | 06/28/2005 | 
| Last Update Date | 11/05/2013 | 
| Medicare PECOS PAC ID | 4587576889 | 
|---|---|
| Medicare Enrollment ID | O20050329001076 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1245236850 | NPI | - | NPPES | 
| ZZZ30855Z | Other | CA | BLUE SHIELD | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 230000014 (California) | Secondary | 
| 282NC0060X | General Acute Care Hospital - Critical Access | 230000014 (California) | Primary | 
| Provider Name | Antonio Domenico Muto-isolani | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1003836594 PECOS PAC ID: 1456340447 Enrollment ID: I20040506000777  | 
| Provider Name | Scott T Landeck | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1790733269 PECOS PAC ID: 9830091578 Enrollment ID: I20040513000609  | 
| Provider Name | Milind R Dhond | 
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) | 
| Provider Identifiers | NPI Number: 1972500676 PECOS PAC ID: 4587656541 Enrollment ID: I20040609001227  | 
| Provider Name | Lars D Ensign | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1750389862 PECOS PAC ID: 4284535428 Enrollment ID: I20041206001082  | 
| Provider Name | Paul S Swanson | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1316945249 PECOS PAC ID: 7416914940 Enrollment ID: I20041218000071  | 
| Provider Name | Ronald S Blustein | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1023129335 PECOS PAC ID: 8729036280 Enrollment ID: I20050111000698  | 
| Provider Name | Quang Dinh Vo | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1568568582 PECOS PAC ID: 0143272757 Enrollment ID: I20050211000306  | 
| Provider Name | Jack M Bertman | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1891777967 PECOS PAC ID: 1052363488 Enrollment ID: I20050214001003  | 
| Provider Name | Mary Alice Morrison | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1639152242 PECOS PAC ID: 5496798779 Enrollment ID: I20050607001243  | 
| Provider Name | Judith E Sherman | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1831216373 PECOS PAC ID: 7315981115 Enrollment ID: I20050613001109  | 
| Provider Name | Christopher W Ward | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1275590549 PECOS PAC ID: 1951337922 Enrollment ID: I20050711000853  | 
| Provider Name | Christine A Spencer | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1417012931 PECOS PAC ID: 9032146725 Enrollment ID: I20050725000734  | 
| Provider Name | Victor G Ettinger | 
|---|---|
| Provider Type | Practitioner - Endocrinology | 
| Provider Identifiers | NPI Number: 1891729653 PECOS PAC ID: 8426088774 Enrollment ID: I20050816000798  | 
| Provider Name | Barnett J. W. Grier | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1932233665 PECOS PAC ID: 5092760652 Enrollment ID: I20060223000847  | 
| Provider Name | Wendy Flapan | 
|---|---|
| Provider Type | Practitioner - Physical Medicine And Rehabilitation | 
| Provider Identifiers | NPI Number: 1588741433 PECOS PAC ID: 0345259065 Enrollment ID: I20060407000285  | 
| Provider Name | Lovsho Phen | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1215996699 PECOS PAC ID: 2961411376 Enrollment ID: I20060412000788  | 
| Provider Name | Raymundo P Punzalan | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1194721373 PECOS PAC ID: 8022117050 Enrollment ID: I20070615000407  | 
| Provider Name | Kenneth P Moses | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1275543845 PECOS PAC ID: 9032206347 Enrollment ID: I20071102000651  | 
| Provider Name | Kenneth L Robinson | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1437157914 PECOS PAC ID: 0749360402 Enrollment ID: I20080107000862  | 
| Provider Name | Ryan A Sipherd | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1477748002 PECOS PAC ID: 4284718719 Enrollment ID: I20080222000236  | 
| Provider Name | William M Mills | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1497779300 PECOS PAC ID: 3779662069 Enrollment ID: I20080512000692  | 
| Provider Name | Paul M Freitas | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1558385641 PECOS PAC ID: 2567531080 Enrollment ID: I20080522000687  | 
| Provider Name | Michael P Brooks | 
|---|---|
| Provider Type | Practitioner - Podiatry | 
| Provider Identifiers | NPI Number: 1881803047 PECOS PAC ID: 5991879223 Enrollment ID: I20080805000728  | 
| Provider Name | Michelle A Kim | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1801982343 PECOS PAC ID: 1759441256 Enrollment ID: I20081113000356  | 
| Provider Name | Charles G Cox | 
|---|---|
| Provider Type | Practitioner - Gastroenterology | 
| Provider Identifiers | NPI Number: 1760467443 PECOS PAC ID: 5092888685 Enrollment ID: I20090303000447  | 
| Provider Name | Marc Nielsen | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1265601207 PECOS PAC ID: 1557496247 Enrollment ID: I20100319000560  | 
| Provider Name | Gail A Prichard | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1891842480 PECOS PAC ID: 6103014568 Enrollment ID: I20101229000462  | 
| Provider Name | Daniel Seth Pine | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1346312097 PECOS PAC ID: 6305034570 Enrollment ID: I20110103000989  | 
| Provider Name | David M Baldini | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1780762526 PECOS PAC ID: 5799965315 Enrollment ID: I20110214000543  | 
| Provider Name | Richard H Printz | 
|---|---|
| Provider Type | Practitioner - Obstetrics/gynecology | 
| Provider Identifiers | NPI Number: 1558437285 PECOS PAC ID: 5395903058 Enrollment ID: I20120227000360  | 
| Provider Name | Ben M Hunt | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1588876593 PECOS PAC ID: 3274703301 Enrollment ID: I20120831000240  | 
| Provider Name | Adam Ouimet | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1699814681 PECOS PAC ID: 3072688407 Enrollment ID: I20121011000769  | 
| Provider Name | Robert Adams | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1396905725 PECOS PAC ID: 7618127465 Enrollment ID: I20121101000350  | 
| Provider Name | Anne Lucy Williams | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1689722829 PECOS PAC ID: 3476792896 Enrollment ID: I20130615000152  | 
| Provider Name | Debra M Ouyang | 
|---|---|
| Provider Type | Practitioner - Endocrinology | 
| Provider Identifiers | NPI Number: 1174753826 PECOS PAC ID: 2163647074 Enrollment ID: I20140709002694  | 
| Provider Name | Katherine G Hemela | 
|---|---|
| Provider Type | Practitioner - Psychiatry | 
| Provider Identifiers | NPI Number: 1730354119 PECOS PAC ID: 2668794728 Enrollment ID: I20141201001942  | 
| Provider Name | Eric Bugna | 
|---|---|
| Provider Type | Practitioner - Orthopedic Surgery | 
| Provider Identifiers | NPI Number: 1255339099 PECOS PAC ID: 1658503768 Enrollment ID: I20150114000443  | 
| Provider Name | John Thomas Hibler | 
|---|---|
| Provider Type | Practitioner - Dermatology | 
| Provider Identifiers | NPI Number: 1588822670 PECOS PAC ID: 6901118660 Enrollment ID: I20161206000056  | 
| Provider Name | Catherine Colpitts | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1285051243 PECOS PAC ID: 9830317742 Enrollment ID: I20170816001767  | 
| Provider Name | Irene Wojtkiewicz | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1093848269 PECOS PAC ID: 1355578097 Enrollment ID: I20180426001881  | 
| Provider Name | Daniel Stoll | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1255713418 PECOS PAC ID: 1951696707 Enrollment ID: I20180905001515  | 
| Provider Name | Robin K Jaquez | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1740366087 PECOS PAC ID: 1850523564 Enrollment ID: I20180914002429  | 
| Provider Name | Christina Kaelin Potter | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1619106408 PECOS PAC ID: 4587829031 Enrollment ID: I20181005001722  | 
| Provider Name | Sunnie Lee Skiles | 
|---|---|
| Provider Type | Practitioner - Pediatric Medicine | 
| Provider Identifiers | NPI Number: 1033281365 PECOS PAC ID: 7214274265 Enrollment ID: I20190129001519  | 
| Provider Name | Kevin Kuo | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1881125573 PECOS PAC ID: 6204172596 Enrollment ID: I20200407003090  | 
| Provider Name | Dana Culp | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1699213967 PECOS PAC ID: 1850701145 Enrollment ID: I20201027001619  | 
| Provider Name | Michelle S Pourtabib | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1003398611 PECOS PAC ID: 5092198366 Enrollment ID: I20220818002890  | 
| Provider Name | Trevor Allen Daniels | 
|---|---|
| Provider Type | Practitioner - Clinical Psychologist | 
| Provider Identifiers | NPI Number: 1952434094 PECOS PAC ID: 0042693160 Enrollment ID: I20220822002764  | 
| Provider Name | Brenda Churchman | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1548709918 PECOS PAC ID: 5294012035 Enrollment ID: I20221121001452  | 
| Provider Name | Kathryn Emily Bynum | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1659002665 PECOS PAC ID: 8325424351 Enrollment ID: I20221214000267  | 
| Provider Name | Brinley Shaw West | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1891567483 PECOS PAC ID: 5799138053 Enrollment ID: I20240202001065  | 
| Provider Name | Jennifer A Vimbor | 
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional | 
| Provider Identifiers | NPI Number: 1346443165 PECOS PAC ID: 3173615127 Enrollment ID: I20240604003322  | 
Eastern Plumas Health Care District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 145 N Pine St, Portola, CA 96122 Phone: 530-832-6500  |