| Mark Twain Medical Center | |
|
430 Sawmill Creek Rd Copperopolis CA 95228 | |
| (209) 785-0000 | |
| (209) 785-7085 |
| Full Name | Mark Twain Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 430 Sawmill Creek Rd, Copperopolis, California |
| Authorized Official Name and Position | Nikki Ochoa (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2094676442 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Twain Medical Center 768 Mountain Ranch Rd San Andreas CA 95249-9707 Ph: (209) 785-7000 | Mark Twain Medical Center 430 Sawmill Creek Rd Copperopolis CA 95228 Ph: (209) 785-0000 |
| NPI Number | 1588725196 |
|---|---|
| Provider Enumeration Date | 12/13/2006 |
| Last Update Date | 08/24/2021 |
| Medicare PECOS PAC ID | 8820073711 |
|---|---|
| Medicare Enrollment ID | O20101101000392 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588725196 | NPI | - | NPPES |
| ========= | Other | WPS TRICARE | |
| ========= | Other | IRS - TAX ID | |
| RHM08548F | Medicaid | CA | |
| ZZZ61268Z | Other | BLUE SHIELD OF CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 030000058 (California) | Primary |
Emotional And Behavioral Helath Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1165 Ranch Rd, Copperopolis, CA 95228 Phone: 209-785-7766 |