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3052 Willow Pass Rd Concord CA 94519-7600 | |
| (925) 957-5429 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3052 Willow Pass Rd, Concord, California |
| Authorized Official Name and Position | Patrick M. Godley (COO / CFO) |
| Authorized Official Contact | 9259575401 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
50 Douglas Dr Suite 391 Martinez CA 94553-4098 Ph: () - | 3052 Willow Pass Rd Concord CA 94519-7600 Ph: (925) 957-5429 |
| NPI Number | 1346328507 |
|---|---|
| Provider Enumeration Date | 11/02/2006 |
| Last Update Date | 04/24/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346328507 | NPI | - | NPPES |
| FHC80120F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 140000090 (California) | Primary |
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