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1191 Phelps Ave Coalinga CA 93210-9609 | |
(559) 935-6400 | |
Not Available |
Full Name | |
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Speciality | General Acute Care Hospital |
Location | 1191 Phelps Ave, Coalinga, California |
Authorized Official Name and Position | Tammy Jean Thompson (EXECUTIVE VP/CFO) |
Authorized Official Contact | 2092876308 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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700 17th St Ste 205 Modesto CA 95354-1249 Ph: (209) 287-6308 | 1191 Phelps Ave Coalinga CA 93210-9609 Ph: (559) 935-6400 |
NPI Number | 1801452941 |
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Provider Enumeration Date | 05/14/2019 |
Last Update Date | 01/24/2022 |
Medicare PECOS PAC ID | 9133559214 |
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Medicare Enrollment ID | O20200414003883 |
Identifier | Type | State | Issuer |
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1801452941 | NPI | - | NPPES |
LTC55539F | Medicaid | CA | |
HSP40397F | Medicaid | CA | |
ZZR00397F | Medicaid | CA |