| |
1415-1423 Fruitvale Ave Oakland CA 94601-2320 | |
(510) 535-8400 | |
(510) 535-8460 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 1415-1423 Fruitvale Ave, Oakland, California |
Authorized Official Name and Position | Jane Garcia (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 5105354000 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 22210 Oakland CA 94623-2210 Ph: (510) 535-4000 | 1415-1423 Fruitvale Ave Oakland CA 94601-2320 Ph: (510) 535-8400 |
NPI Number | 1629379896 |
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Provider Enumeration Date | 11/04/2010 |
Last Update Date | 02/02/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629379896 | NPI | - | NPPES |
0191 | Other | CA | AC BHCS |
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