{"npi":"1962530725","type":"NPI-2","status":"active","name":{"display":"Redwood Coast Medical Services, Inc.","other":[],"organization_name":"REDWOOD COAST MEDICAL SERVICES, INC.","authorised_official":"Diane Agee"},"specialty":{"primary_taxonomy":"261QF0400X","primary_taxonomy_description":"Federally Qualified Health Center","slug":"fqhc","schema_org_specialty":"PrimaryCare","all":[{"code":"261QF0400X","description":"Federally Qualified Health Center","primary":true,"state":"CA","license":"110000048"}]},"addresses":[{"purpose":"LOCATION","street_1":"46900 OCEAN DR","city":"GUALALA","state":"CA","postal_code":"954458353","country_code":"US","phone":"7078844005","fax":"7078849728"},{"purpose":"MAILING","street_1":"PO BOX 1100","city":"GUALALA","state":"CA","postal_code":"954451100","country_code":"US","phone":"7078844005","fax":"7078849728"}],"license":{"state":"CA","number":"110000048"},"identifiers":[{"type_code":"05","label":"Medicaid","value":"FHC03906F","state":"CA","issuer":null}],"pecos":{"enrolled_at":"2026-05-09T10:41:39.028268+00:00","enrollments":[{"enrlmt_id":"O20100302000446","type_code":"12-70","type_desc":"PART B SUPPLIER - CLINIC/GROUP PRACTICE","state":"CA","pac_id":"6901941905"},{"enrlmt_id":"O20110118000397","type_code":"00-04","type_desc":"PART A PROVIDER - FEDERALLY QUALIFIED HEALTH CENTER (FQHC)","state":"CA","pac_id":"6901941905"}]},"enumeration_date":"2007-03-01","last_updated":"2013-12-24","_meta":{"source":"NPPES","snapshot_date":"2013-12-24","doc_url":"https://findmynpi.com/api"}}