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39100 Contreras Rd Suite C Anza CA 92539-8724 | |
(951) 763-4835 | |
(951) 763-0495 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 39100 Contreras Rd, Anza, California |
Authorized Official Name and Position | William Thomsen (CEO) |
Authorized Official Contact | 9098641097 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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11980 Mount Vernon Ave Grand Terrace CA 92313-5172 Ph: (909) 864-1097 | 39100 Contreras Rd Suite C Anza CA 92539-8724 Ph: (951) 763-4835 |
NPI Number | 1659424885 |
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Provider Enumeration Date | 01/19/2007 |
Last Update Date | 08/25/2021 |
Identifier | Type | State | Issuer |
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1659424885 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
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 |