Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 140 C 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 | 140 C St Lemoore CA 93245-2929 Ph: (559) 924-7005 |
NPI Number | 1073868527 |
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Provider Enumeration Date | 07/20/2012 |
Last Update Date | 07/09/2024 |
Medicare PECOS PAC ID | 5597782144 |
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Medicare Enrollment ID | O20120814000182 |
Identifier | Type | State | Issuer |
---|---|---|---|
1073868527 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550001875 (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 | |