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215 W Beamer St Woodland CA 95695-2510 | |
(530) 666-8960 | |
(530) 666-8527 |
Full Name | |
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Speciality | Clinic/Center |
Location | 215 W Beamer St, Woodland, California |
Authorized Official Name and Position | Rose Macisaac (CFO) |
Authorized Official Contact | 7607676435 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 1260 Davis CA 95617-1260 Ph: (530) 753-3498 | 215 W Beamer St Woodland CA 95695-2510 Ph: (530) 666-8960 |
NPI Number | 1558469064 |
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Provider Enumeration Date | 09/20/2006 |
Last Update Date | 10/17/2023 |
Medicare PECOS PAC ID | 7315934767 |
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Medicare Enrollment ID | O20240117000724 |
Identifier | Type | State | Issuer |
---|---|---|---|
1558469064 | NPI | - | NPPES |
FHC70985F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 030000770 (California) | Primary |
Molina Medical Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3 Court St, Woodland, CA 95695 Phone: 530-668-9293 Fax: 530-668-0231 | |
Northern Valley Indian Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1280 E Gibson Rd, Woodland, CA 95776 Phone: 530-207-5499 |