Golden Valley Health Center | |
13161 Jefferson St Le Grand CA 95333-9766 | |
(209) 389-1900 | |
(209) 389-1907 |
Full Name | Golden Valley Health Center |
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Speciality | Clinic/Center |
Location | 13161 Jefferson St, Le Grand, California |
Authorized Official Name and Position | Tony Weber (CEO) |
Authorized Official Contact | 2093846493 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Golden Valley Health Center 737 W Childs Ave Merced CA 95341-6805 Ph: (209) 384-6493 | Golden Valley Health Center 13161 Jefferson St Le Grand CA 95333-9766 Ph: (209) 389-1900 |
NPI Number | 1356325310 |
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Provider Enumeration Date | 12/02/2005 |
Last Update Date | 02/09/2017 |
Medicare PECOS PAC ID | 4183527187 |
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Medicare Enrollment ID | O20111109000162 |
Identifier | Type | State | Issuer |
---|---|---|---|
1356325310 | NPI | - | NPPES |
CMM71050F | Medicaid | CA | |
040000373 | Other | CA | STATE OF CA LIC# |
ZZZ52122Z | Other | CA | BLUE SHIELD OF CA GRP PIN |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 040000373 (California) | Primary |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13161 Jefferson St, Le Grand, CA 95333 Phone: 209-389-1900 | |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13162 Jefferson St, Le Grand, CA 95333 Phone: 209-389-1900 Fax: 209-384-3966 |