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359 Lakeport Blvd Lakeport CA 95453-5412 | |
(707) 533-2700 | |
(707) 263-5400 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 359 Lakeport Blvd, Lakeport, California |
Authorized Official Name and Position | Ernesto Padilla (EXECUTIVE DIRECTOR) |
Authorized Official Contact | 7072630329 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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Po Box 1950 Lakeport CA 95453-1950 Ph: (707) 263-8382 | 359 Lakeport Blvd Lakeport CA 95453-5412 Ph: (707) 533-2700 |
NPI Number | 1215327804 |
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Provider Enumeration Date | 02/03/2015 |
Last Update Date | 04/27/2022 |
Identifier | Type | State | Issuer |
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1215327804 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 1st St, Ste 210, Lakeport, CA 95453 Phone: 707-462-1516 Fax: 707-462-1178 | |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 11th St, Lakeport, CA 95453 Phone: 707-263-3746 | |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5108 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-1840 Fax: 707-262-5844 | |