| Daly City Youth Hlth Ctr | |
|
350 90th Street Daly City CA 94015-1634 | |
| (650) 985-7000 | |
| (605) 301-8626 |
| Full Name | Daly City Youth Hlth Ctr |
|---|---|
| Speciality | Clinic/Center |
| Location | 350 90th Street, Daly City, California |
| Authorized Official Name and Position | David Mcgrew (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6505732096 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Daly City Youth Hlth Ctr 222 39th Avenue San Mateo CA 94403-4364 Ph: (650) 573-2222 | Daly City Youth Hlth Ctr 350 90th Street Daly City CA 94015-1634 Ph: (650) 985-7000 |
| NPI Number | 1023196011 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 10/01/2018 |
| Medicare PECOS PAC ID | 9032023171 |
|---|---|
| Medicare Enrollment ID | O20161007001049 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023196011 | NPI | - | NPPES |
| FHC80181F | Medicaid | CA | |
| FHC80181F | Other | CA | FQHC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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