| Indian Health Center Of Santa Clara Valley - Forest Dental | |
|
2039 Forest Ave Ste 204b San Jose CA 95128-4815 | |
| (408) 445-3400 | |
| Not Available |
| Full Name | Indian Health Center Of Santa Clara Valley - Forest Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2039 Forest Ave Ste 204b, San Jose, California |
| Authorized Official Name and Position | Aldon Wayne Scott (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 4084453400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Health Center Of Santa Clara Valley - Forest Dental 1333 Meridian Ave San Jose CA 95125-5212 Ph: (408) 445-3400 | Indian Health Center Of Santa Clara Valley - Forest Dental 2039 Forest Ave Ste 204b San Jose CA 95128-4815 Ph: (408) 445-3400 |
| NPI Number | 1437607355 |
|---|---|
| Provider Enumeration Date | 09/20/2016 |
| Last Update Date | 09/20/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437607355 | NPI | - | NPPES |
| FHC11833F | Other | CA | STATE PROGRAM |
| FHC11833F | Other | CA | MEDI-CAL |
| 55-1137 | Other | CA | MEDICARE PALMETTO |
| FHC11833F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 070000118 (California) | Primary |
Chris Chung, Md, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 455 Oconnor Dr, #150, San Jose, CA 95128 Phone: 408-293-7767 Fax: 408-294-6595 | |
Tuan Le, M.d. A Professional Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1569 Lexann Ave, Suite 122, San Jose, CA 95121 Phone: 408-531-1555 | |
Frank D. Shin, Md, Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1440 S De Anza Blvd, Suite A, San Jose, CA 95129 Phone: 408-366-0405 | |
Verity Medical Foundation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 227 N Jackson Ave, San Jose, CA 95116 Phone: 408-278-3000 | |
Leena Gupta Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4945 Bridgeview Ln, San Jose, CA 95138 Phone: 408-666-0392 | |
Shen Medicine & Pediatrics Assc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 316 Rosewood Ave, San Jose, CA 95117 Phone: 408-296-9800 Fax: 408-296-9805 | |
Terry C. Lin D.o.,inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2520 Samaritan Dr., #201, San Jose, CA 95124 Phone: 888-582-0814 |