| Chapcare-fair Oaks | |
|
1855 N Fair Oaks Ave Pasadena CA 91103-1620 | |
| (626) 398-6300 | |
| (626) 398-5948 |
| Full Name | Chapcare-fair Oaks |
|---|---|
| Speciality | Clinic/Center |
| Location | 1855 N Fair Oaks Ave, Pasadena, California |
| Authorized Official Name and Position | Margaret Banda Martinez (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 6269931227 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Chapcare-fair Oaks 455 W Montana St Pasadena CA 91103-1327 Ph: (626) 993-1212 | Chapcare-fair Oaks 1855 N Fair Oaks Ave Pasadena CA 91103-1620 Ph: (626) 398-6300 |
| NPI Number | 1871689315 |
|---|---|
| Provider Enumeration Date | 10/04/2006 |
| Last Update Date | 11/12/2015 |
| Medicare PECOS PAC ID | 4789628512 |
|---|---|
| Medicare Enrollment ID | O20110317000274 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871689315 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 960001053 (California) | Primary |
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