| Escalon Community Health Clinic | |
|
2080 Mchenry Ave # 100 Escalon CA 95320-9484 | |
| (209) 847-3011 | |
| (209) 848-4110 |
| Full Name | Escalon Community Health Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2080 Mchenry Ave # 100, Escalon, California |
| Authorized Official Name and Position | Ann Croskrey (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2098484104 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Escalon Community Health Clinic 350 S Oak Ave Oakdale CA 95361-3519 Ph: (209) 847-3011 | Escalon Community Health Clinic 2080 Mchenry Ave # 100 Escalon CA 95320-9484 Ph: (209) 847-3011 |
| NPI Number | 1770624553 |
|---|---|
| Provider Enumeration Date | 02/12/2007 |
| Last Update Date | 12/18/2020 |
| Medicare PECOS PAC ID | 5496736613 |
|---|---|
| Medicare Enrollment ID | O20040525000978 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770624553 | NPI | - | NPPES |
| RHM08606F | Medicaid | CA | |
| BCP08606F | Medicaid | CA | |
| HAP08606F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 030000069 (California) | Primary |
B D Peterson Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2390 Jackson Ave, Escalon, CA 95320 Phone: 209-838-6015 Fax: 209-838-0750 | |
Krishnamoorthi M. D. Inc., A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 850 California St, Escalon, CA 95320 Phone: 209-838-2278 |