| Independence Community Treatment Clinic | |
|
38801 Clock Tower Plaza Dr E Room Community Building,104,105,106,107 Palmdale CA 93550-3346 | |
| (818) 776-1755 | |
| (818) 776-1657 |
| Full Name | Independence Community Treatment Clinic |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 38801 Clock Tower Plaza Dr E, Palmdale, California |
| Authorized Official Name and Position | Alex Brnzburg (PROGRAM DIRECTOR) |
| Authorized Official Contact | 8187761755 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Independence Community Treatment Clinic 19231 Victory Blvd Suite 554 Reseda CA 91335-6308 Ph: (818) 776-1755 | Independence Community Treatment Clinic 38801 Clock Tower Plaza Dr E Room Community Building,104,105,106,107 Palmdale CA 93550-3346 Ph: (818) 776-1755 |
| NPI Number | 1710122866 |
|---|---|
| Provider Enumeration Date | 12/03/2008 |
| Last Update Date | 12/11/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710122866 | NPI | - | NPPES |
| CMM70956F | Medicaid | CA | |
| 196856000 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 960001358 (California) | Primary |
Inpatient Services Of California Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38600 Medical Center Dr, Palmdale, CA 93551 Phone: 661-382-5000 | |
Palmdale Intensivist Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38600 Medical Center Dr, Palmdale, CA 93551 Phone: 661-382-5000 | |
South Valley Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 38350 40th St E, Palmdale, CA 93552 Phone: 661-272-5001 | |
Independence Community Treatment Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 190 Sierra Ct, Suite C-8, Palmdale, CA 93550 Phone: 818-776-1755 | |
Garrison Family Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 41210 11th St W Ste C, Palmdale, CA 93551 Phone: 661-947-7100 Fax: 661-947-5151 | |
Prime Source Testing Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 190 Sierra Ct Ste 327, Palmdale, CA 93550 Phone: 337-781-5038 | |
Nikta Chiropractic, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1020 E Palmdale Blvd, Suite 101c, Palmdale, CA 93550 Phone: 661-266-1611 Fax: 661-266-1295 |