| Community Medical Centers, Waterloo | |
|
1031 Waterloo Rd Stockton CA 95205-4256 | |
| (209) 940-5600 | |
| (209) 940-5065 |
| Full Name | Community Medical Centers, Waterloo |
|---|---|
| Speciality | Clinic/Center |
| Location | 1031 Waterloo Rd, Stockton, California |
| Authorized Official Name and Position | Art Feagles (CFO) |
| Authorized Official Contact | 2093732803 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Centers, Waterloo 7210 Murray Dr Stockton CA 95210-3339 Ph: (209) 373-2800 | Community Medical Centers, Waterloo 1031 Waterloo Rd Stockton CA 95205-4256 Ph: (209) 940-5600 |
| NPI Number | 1285059923 |
|---|---|
| Provider Enumeration Date | 03/04/2014 |
| Last Update Date | 06/16/2015 |
| Medicare PECOS PAC ID | 8426968520 |
|---|---|
| Medicare Enrollment ID | O20141112002250 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285059923 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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