| Family Medical Center - Angels Camp | |
|
590 Stanislaus Avenue Angels Camp CA 95222-0000 | |
| (209) 736-0813 | |
| (209) 736-9088 |
| Full Name | Family Medical Center - Angels Camp |
|---|---|
| Speciality | Clinic/Center |
| Location | 590 Stanislaus Avenue, Angels Camp, California |
| Authorized Official Name and Position | Chris Roberts (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 2097542614 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Medical Center - Angels Camp 768 Mountain Ranch Road San Andreas CA 95249-9707 Ph: (209) 754-2520 | Family Medical Center - Angels Camp 590 Stanislaus Avenue Angels Camp CA 95222-0000 Ph: (209) 736-0813 |
| NPI Number | 1942362561 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 06/09/2020 |
| Medicare PECOS PAC ID | 8820073711 |
|---|---|
| Medicare Enrollment ID | O20100622000789 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942362561 | NPI | - | NPPES |
| ========= | Other | IRS - TAX ID | |
| RHM18574F | Medicaid | CA | |
| ========= | Other | WPS TRICARE | |
| ZZZ61267Z | Other | BLUE SHIELD OF CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 030000058 (California) | Primary |
Yin Yang Medical Spa, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1270 Suzanne Dr Ste A, Angels Camp, CA 95222 Phone: 209-736-0100 Fax: 209-736-0128 | |
Angels Camp Family Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 445 South Main St, Angels Camp, CA 95222 Phone: 209-736-0249 Fax: 209-533-7696 |