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29490 Lakeview Ave Nuevo CA 92567-9705 | |
(951) 928-2805 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 29490 Lakeview Ave, Nuevo, California |
Authorized Official Name and Position | Judy Stith (CFO) |
Authorized Official Contact | 7609694516 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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1695 N Sunrise Way Palm Springs CA 92262-3701 Ph: (760) 323-2118 | 29490 Lakeview Ave Nuevo CA 92567-9705 Ph: (951) 928-2805 |
NPI Number | 1881389583 |
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Provider Enumeration Date | 04/07/2023 |
Last Update Date | 05/09/2023 |
Identifier | Type | State | Issuer |
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1881389583 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |