Basic Information
| Provider Information | |||||||||
| NPI: | 1427342930 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | US DEPT OF THE INTERIOR NATIONAL PARK SERVICE | ||||||||
| LastName: | |||||||||
| FirstName: | |||||||||
| MiddleName: | |||||||||
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| Credential: | |||||||||
| OtherOrganizationName: | YOSEMITE MEDICAL CLINIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
| OtherLastName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 550 | ||||||||
| Address2: | |||||||||
| City: | YOSEMITE NATIONAL PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953890550 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093724637 | ||||||||
| FaxNumber: | 2093724330 | ||||||||
| Practice Location | |||||||||
| Address1: | 9000 AHWAHNEE DRIVE | ||||||||
| Address2: | ATTN: R MADRID | ||||||||
| City: | YOSEMITE NATIONAL PARK | ||||||||
| State: | CA | ||||||||
| PostalCode: | 95389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2093724637 | ||||||||
| FaxNumber: | 2093724330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/01/2011 | ||||||||
| LastUpdateDate: | 10/07/2022 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | ULRICH | ||||||||
| AuthorizedOfficialFirstName: | PATTAMA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | HEALTH SYSTEM ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 2093720814 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | |||||||||
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| AuthorizedOfficialCredential: | RN | ||||||||
| NPICertificationDate: | 10/07/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QU0200X | Y | Ambulatory Health Care Facilities | Clinic/Center | Urgent Care |
No ID Information.