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Contact Information

JACK L BELLAH, MD
721 RIVER DR
SUITE B
FORT BRAGG, CA95437
 Phone: 707-964-6910
 Fax: 707-964-7430
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
Indicates primary specialty

NPI Profile & details for JACK L BELLAH · (Male)

NPI # 1235225376
Status Active
Credentials MD
Entity Individual
Enumeration date 10/05/2006
Last updated 10/10/2012 - About 14 years ago
Sole proprietor 1 Yes
Identifiers
  • CA License # G47828
Hospital affiliation(s)
  • SUTTER COAST HOSPITAL - (Acute Care)
    800 E WASHINGTON BLVD
    CRESCENT CITY, CA 95531
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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