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56030 Highway 371 Anza CA 92539-0799 | |
(925) 763-2700 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Rural Health |
Location | 56030 Highway 371, Anza, California |
Authorized Official Name and Position | Nan Marie Kelly (CO-MANAGER,PROVIDER) |
Authorized Official Contact | 9517632700 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 390799 Anza CA 92539-0799 Ph: (951) 763-2700 | 56030 Highway 371 Anza CA 92539-0799 Ph: (925) 763-2700 |
NPI Number | 1376744326 |
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Provider Enumeration Date | 05/29/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
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1376744326 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261Q00000X | Clinic/center | (* (Not Available)) | Primary |
261QR1300X | Clinic/center - Rural Health | (* (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 | |