| Community Clinic South | |
|
284 Pennsylvania Dr Ste 1&2 Watsonville CA 95076-3768 | |
| (831) 319-4200 | |
| (831) 319-4204 |
| Full Name | Community Clinic South |
|---|---|
| Speciality | Clinic/Center |
| Location | 284 Pennsylvania Dr Ste 1&2, Watsonville, California |
| Authorized Official Name and Position | Amber Williams (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 8312787906 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Clinic South 200 7th Avenue Suite 150 Santa Cruz CA 95062-4668 Ph: (831) 462-1060 | Community Clinic South 284 Pennsylvania Dr Ste 1&2 Watsonville CA 95076-3768 Ph: (831) 319-4200 |
| NPI Number | 1649601550 |
|---|---|
| Provider Enumeration Date | 12/02/2013 |
| Last Update Date | 02/23/2022 |
| Certification Date | 02/23/2022 |
| Medicare PECOS PAC ID | 6608202171 |
|---|---|
| Medicare Enrollment ID | O20200130003075 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649601550 | NPI | - | NPPES |
| 44AB | Medicaid | CA | |
| 44AC | Medicaid | CA |
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