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5200 Stockton Blvd Ste 110 Sacramento CA 95820-5492 | |
| (916) 642-1867 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 5200 Stockton Blvd Ste 110, Sacramento, California |
| Authorized Official Name and Position | Jerry T Bliatout (CEO) |
| Authorized Official Contact | 9166421867 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3030 Explorer Dr Sacramento CA 95827-2728 Ph: () - | 5200 Stockton Blvd Ste 110 Sacramento CA 95820-5492 Ph: (916) 642-1867 |
| NPI Number | 1497575948 |
|---|---|
| Provider Enumeration Date | 10/10/2024 |
| Last Update Date | 02/04/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497575948 | NPI | - | NPPES |
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