| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 131 W A St, Dixon, California |
| Authorized Official Name and Position | Michael H. Kirkpatrick (CEO) |
| Authorized Official Contact | 2093732833 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 779 Stockton CA 95201-0779 Ph: (707) 635-1600 | 131 W A St Dixon CA 95620-3437 Ph: (707) 635-1600 |
| NPI Number | 1578685137 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1578685137 | NPI | - | NPPES |
| HAP03864F | Other | CA | SOFP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (California) | Primary |
Dixon Dialysis Services Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 125 N Lincoln St, Ste B, Dixon, CA 95620 Phone: 707-678-6433 Fax: 707-678-4879 | |