Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 16233 King St, Delhi, California |
Authorized Official Name and Position | Leslie Tamiko Mcgowan (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 2093947913 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1140 Main St Livingston CA 95334-1257 Ph: (209) 394-7913 | 16233 King St Delhi CA 95315 Ph: (209) 394-7913 |
NPI Number | 1730530254 |
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Provider Enumeration Date | 06/27/2016 |
Last Update Date | 05/10/2017 |
Identifier | Type | State | Issuer |
---|---|---|---|
1730530254 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |