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199 Reynolds Road Chester CA 96020 | |
(530) 258-2826 | |
(530) 258-3471 |
Full Name | |
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Speciality | Clinic/Center |
Location | 199 Reynolds Road, Chester, California |
Authorized Official Name and Position | Linda Wagner (CEO) |
Authorized Official Contact | 5302582067 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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P.o. Box 737 Chester CA 96020 Ph: (530) 258-2151 | 199 Reynolds Road Chester CA 96020 Ph: (530) 258-2826 |
NPI Number | 1104920438 |
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Provider Enumeration Date | 09/08/2006 |
Last Update Date | 05/21/2014 |
Medicare PECOS PAC ID | 8820907140 |
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Medicare Enrollment ID | O20030312000027 |
Identifier | Type | State | Issuer |
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1104920438 | NPI | - | NPPES |
RHM08593F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary |