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3567 Mt. Whitney Avenue Riverdale CA 93656 | |
(559) 638-2154 | |
(559) 638-2156 |
Full Name | |
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Speciality | Clinic/Center |
Location | 3567 Mt. Whitney Avenue, Riverdale, California |
Authorized Official Name and Position | Andrea Kofl (CENTRAL VALLEY NETWORK PRESIDENT) |
Authorized Official Contact | 5595370056 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 888806 Los Angeles CA 90088-8806 Ph: (559) 638-2154 | 3567 Mt. Whitney Avenue Riverdale CA 93656 Ph: (559) 638-2154 |
NPI Number | 1679819742 |
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Provider Enumeration Date | 12/18/2012 |
Last Update Date | 04/08/2022 |
Medicare PECOS PAC ID | 0941460984 |
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Medicare Enrollment ID | O20130315000399 |
Identifier | Type | State | Issuer |
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1679819742 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | 040000149 (California) | Primary |
Central Valley Maternal & Child Care Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3567 W. Mt. Whitney Ave., Riverdale, CA 93656 Phone: 559-867-4416 Fax: 559-867-3010 | |
Central Valley Multispecialty Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20647 Malsbary St, Riverdale, CA 93656 Phone: 559-867-4416 | |