| Lawrence Family Center & Clinic | |
|
721 Calaveras Street Lodi CA 95240-0628 | |
| (209) 331-8019 | |
| (209) 331-8018 |
| Full Name | Lawrence Family Center & Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 721 Calaveras Street, Lodi, California |
| Authorized Official Name and Position | Michael H. Kirkpatrick (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2093732833 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lawrence Family Center & Clinic Po Box 779 Stockton CA 95201-0779 Ph: (209) 373-2833 | Lawrence Family Center & Clinic 721 Calaveras Street Lodi CA 95240-0628 Ph: (209) 331-8019 |
| NPI Number | 1659435279 |
|---|---|
| Provider Enumeration Date | 12/20/2006 |
| Last Update Date | 12/03/2008 |
| Medicare PECOS PAC ID | 8426968520 |
|---|---|
| Medicare Enrollment ID | O20070227000817 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659435279 | NPI | - | NPPES |
| FHC70460F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 0300000424 (California) | Primary |
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