Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 555 E St, Lemoore, California |
Authorized Official Name and Position | John D Blaine (CEO/ADMINISTRATOR) |
Authorized Official Contact | 5593864500 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 580 Lemoore CA 93245-0580 Ph: (559) 386-4500 | 555 E St Lemoore CA 93245-2617 Ph: (559) 386-4500 |
NPI Number | 1225387616 |
---|---|
Provider Enumeration Date | 08/31/2012 |
Last Update Date | 12/29/2022 |
Medicare PECOS PAC ID | 5597782144 |
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Medicare Enrollment ID | O20150508000912 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225387616 | NPI | - | NPPES |
751139 | Other | CA | MEDICARE OSCAR CERTIFICATION |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550002057 (California) | Primary |
Health Valley Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 812 E D St, Lemoore, CA 93245 Phone: 559-925-1000 Fax: 559-925-1084 | |
Nahid Eskandari, Md Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 810 E D St, Lemoore, CA 93245 Phone: 559-924-7711 | |