| Freedom Choice Clinic | |
|
2690 S White Rd Suite 95 San Jose CA 95148-2076 | |
| (408) 223-8080 | |
| Not Available |
| Full Name | Freedom Choice Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 2690 S White Rd, San Jose, California |
| Authorized Official Name and Position | Miguel A Darantes (MEDICAL DIRECTOR/OWNER) |
| Authorized Official Contact | 4082238080 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Freedom Choice Clinic 2690 S. White Rd #20 San Jose CA 95148-2076 Ph: (408) 223-8080 | Freedom Choice Clinic 2690 S White Rd Suite 95 San Jose CA 95148-2076 Ph: (408) 223-8080 |
| NPI Number | 1164968178 |
|---|---|
| Provider Enumeration Date | 01/13/2017 |
| Last Update Date | 03/10/2022 |
| Medicare PECOS PAC ID | 3870860877 |
|---|---|
| Medicare Enrollment ID | O20170523001297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164968178 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A101639 (California) | Primary |
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