| Lifelong Medical Care Richmond Clinic | |
|
2400 Nevin Ave Richmond CA 94804-1700 | |
| (510) 215-5001 | |
| (510) 215-1115 |
| Full Name | Lifelong Medical Care Richmond Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2400 Nevin Ave, Richmond, California |
| Authorized Official Name and Position | Rick Clark (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5109814122 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lifelong Medical Care Richmond Clinic Po Box 11247 Berkeley CA 94712-2247 Ph: (510) 215-5001 | Lifelong Medical Care Richmond Clinic 2400 Nevin Ave Richmond CA 94804-1700 Ph: (510) 215-5001 |
| NPI Number | 1699029330 |
|---|---|
| Provider Enumeration Date | 11/02/2012 |
| Last Update Date | 11/02/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699029330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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