Basic Information
| Provider Information | |||||||||
| NPI: | 1023047693 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | YOSEMITE MEDICAL CLINIC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1319 | ||||||||
| Address2: | |||||||||
| City: | SALIDA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953681319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095436279 | ||||||||
| FaxNumber: | 2095436280 | ||||||||
| Practice Location | |||||||||
| Address1: | 9000 AHWAHNEE DRIVE | ||||||||
| Address2: | |||||||||
| City: | YOSEMITE NATIONAL PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093724637 | ||||||||
| FaxNumber: | 2093724330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/03/2006 | ||||||||
| LastUpdateDate: | 07/28/2016 | ||||||||
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| AuthorizedOfficialLastName: | KAUFMAN | ||||||||
| AuthorizedOfficialFirstName: | RONALD | ||||||||
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| AuthorizedOfficialTitleorPosition: | REGIONAL CMO; TENET | ||||||||
| AuthorizedOfficialTelephone: | 7144286812 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.