| Channel Medical Center | |
|
701 E Channel St Stockton CA 95202-2628 | |
| (209) 944-4700 | |
| (209) 944-6715 |
| Full Name | Channel Medical Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 701 E Channel St, Stockton, California |
| Authorized Official Name and Position | Michael H Kirkpatrick (CEO) |
| Authorized Official Contact | 2093732833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Channel Medical Center Po Box 779 Stockton CA 95201-0779 Ph: (209) 373-2800 | Channel Medical Center 701 E Channel St Stockton CA 95202-2628 Ph: (209) 944-4700 |
| NPI Number | 1578552543 |
|---|---|
| Provider Enumeration Date | 10/20/2005 |
| Last Update Date | 07/14/2010 |
| Medicare PECOS PAC ID | 8426968520 |
|---|---|
| Medicare Enrollment ID | O20100824000128 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578552543 | NPI | - | NPPES |
| FHC70629F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 030000561 (California) | Primary |
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