| |
3567 W Mt Whitney Ave Riverdale CA 93656 | |
(559) 867-4415 | |
(559) 867-0152 |
Full Name | |
---|---|
Speciality | Clinic/center - Primary Care |
Location | 3567 W Mt Whitney Ave, Riverdale, 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 | 3567 W Mt Whitney Ave Riverdale CA 93656 Ph: (559) 867-4415 |
NPI Number | 1609077684 |
---|---|
Provider Enumeration Date | 05/29/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1609077684 | NPI | - | NPPES |
GR0052461 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
Central Valley Maternal & Child Care Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3567 W. Mt. Whitney Ave., Riverdale, CA 93656 Phone: 559-867-4416 Fax: 559-867-3010 | |
Central Valley Multispecialty Medical Group, Inc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 20647 Malsbary St, Riverdale, CA 93656 Phone: 559-867-4416 | |