| |
1824 55th Ave Oakland CA 94621-4314 | |
(281) 782-5887 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Community Health |
Location | 1824 55th Ave, Oakland, California |
Authorized Official Name and Position | Orlando Gillam (CEO) |
Authorized Official Contact | 2817825887 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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823 W Sussex Way Fresno CA 93705-2021 Ph: (281) 782-5887 | 1824 55th Ave Oakland CA 94621-4314 Ph: (281) 782-5887 |
NPI Number | 1164792610 |
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Provider Enumeration Date | 12/30/2011 |
Last Update Date | 12/30/2011 |
Identifier | Type | State | Issuer |
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1164792610 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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