Family Medical Center - Copperopolis | |
430 Sawmill Creek Rd Copperopolis CA 95228 | |
(209) 785-0000 | |
(209) 785-7085 |
Full Name | Family Medical Center - Copperopolis |
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Speciality | Clinic/Center |
Location | 430 Sawmill Creek Rd, Copperopolis, California |
Authorized Official Name and Position | Nikki Ochoa (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 2094676442 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Medical Center - Copperopolis 768 Mountain Ranch Rd San Andreas CA 95249-9707 Ph: (209) 785-7000 | Family Medical Center - Copperopolis 430 Sawmill Creek Rd Copperopolis CA 95228 Ph: (209) 785-0000 |
NPI Number | 1588725196 |
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Provider Enumeration Date | 12/13/2006 |
Last Update Date | 08/24/2021 |
Medicare PECOS PAC ID | 8820073711 |
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Medicare Enrollment ID | O20101101000392 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588725196 | NPI | - | NPPES |
========= | Other | WPS TRICARE | |
========= | Other | IRS - TAX ID | |
RHM08548F | Medicaid | CA | |
ZZZ61268Z | Other | BLUE SHIELD OF CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QR1300X | Clinic/center - Rural Health | 030000058 (California) | Primary |
Emotional And Behavioral Helath Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1165 Ranch Rd, Copperopolis, CA 95228 Phone: 209-785-7766 |