| Delta Health Care | |
|
1425 S Center St Stockton CA 95206-2016 | |
| (209) 751-3920 | |
| (209) 751-3914 |
| Full Name | Delta Health Care |
|---|---|
| Speciality | Clinic/center |
| Location | 1425 S Center St, Stockton, California |
| Authorized Official Name and Position | Brent Andrew Williams (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 2097513920 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Delta Health Care Po Box 550 Stockton CA 95201-0550 Ph: (209) 751-3920 | Delta Health Care 1425 S Center St Stockton CA 95206-2016 Ph: (209) 751-3920 |
| NPI Number | 1407934458 |
|---|---|
| Provider Enumeration Date | 11/01/2006 |
| Last Update Date | 04/21/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407934458 | NPI | - | NPPES |
| EAP11503G | Other | CA | EAPC |
| CMM70825F | Medicaid | CA | |
| CMM70920F | Medicaid | CA | |
| CMM70817F | Medicaid | CA | |
| ZZR11503G | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 030000682 (California) | Primary |
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