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58581 Us Highway 371 Suites F, G, & H Anza CA 92539 | |
(619) 344-2815 | |
(619) 398-2412 |
Full Name | |
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Speciality | Clinic/Center |
Location | 58581 Us Highway 371, Anza, California |
Authorized Official Name and Position | Judy Stith (CHIEF ADMINISTRATIVE OFFICER) |
Authorized Official Contact | 7603232118 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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1695 N. Sunrise Way Palm Springs CA 92262 Ph: (760) 323-2118 | 58581 Us Highway 371 Suites F, G, & H Anza CA 92539 Ph: (619) 344-2815 |
NPI Number | 1942623657 |
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Provider Enumeration Date | 01/31/2014 |
Last Update Date | 03/08/2024 |
Medicare PECOS PAC ID | 6002989522 |
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Medicare Enrollment ID | O20240606003239 |
Identifier | Type | State | Issuer |
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1942623657 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Anza Community Medical Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 56480 Highway 371, Anza, CA 92539 Phone: 951-694-8549 Fax: 951-694-0249 | |