Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 8787 Hall Rd, Lamont, California |
Authorized Official Name and Position | Olga Meave (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 6616353050 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Po Box 1559 Bakersfield CA 93302-1559 Ph: (661) 635-3050 | 8787 Hall Rd Lamont CA 93241-1953 Ph: (661) 845-3731 |
NPI Number | 1629070461 |
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Provider Enumeration Date | 08/11/2005 |
Last Update Date | 06/22/2023 |
Medicare PECOS PAC ID | 3870407505 |
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Medicare Enrollment ID | O20100618000368 |
Identifier | Type | State | Issuer |
---|---|---|---|
1629070461 | NPI | - | NPPES |
GR 0053190 | Other | CA | INPATIENT BILLING |
HAP03895F | Other | CA | FAMILY PACT |
BCP03895F | Other | CA | CDP |
FHC 03895F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Clinica Del Pueblo Medical Group Corp Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10200 Main St Ste B, Lamont, CA 93241 Phone: 661-845-1788 Fax: 661-845-1791 | |
Del Pueblo Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10200 Main St, Lamont, CA 93241 Phone: 661-845-1788 Fax: 661-845-1791 | |
Clinica Del Pueblo Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 10200 Main St, Lamont, CA 93241 Phone: 661-845-2399 Fax: 661-845-1791 |