Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 10769 14th Ave, Armona, California |
Authorized Official Name and Position | Charles Smith (C.O.O.) |
Authorized Official Contact | 5598674416 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 543 Riverdale CA 93656-0543 Ph: (559) 867-4416 | 10769 14th Ave Armona CA 93202 Ph: (559) 583-7200 |
NPI Number | 1598966491 |
---|---|
Provider Enumeration Date | 05/29/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598966491 | NPI | - | NPPES |
GR0052467 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |