| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 1717 5th St, Davis, California |
| Authorized Official Name and Position | Rose Macisaac (CFO) |
| Authorized Official Contact | 7607676435 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1260 Davis CA 95617-1260 Ph: (530) 753-3498 | 1717 5th St Davis CA 95616-3945 Ph: (530) 758-0354 |
| NPI Number | 1215561808 |
|---|---|
| Provider Enumeration Date | 02/24/2020 |
| Last Update Date | 10/17/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215561808 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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Scriven Chiropractic Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1403 5th St Ste B, Davis, CA 95616 Phone: 707-225-4600 | |
Communicare Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2051 John Jones Rd, Davis, CA 95616 Phone: 530-758-3498 Fax: 530-758-8490 | |