| Mountain Empire School Clinic | |
|
3291 Buckman Springs Rd Pine Valley CA 91962-4003 | |
| (619) 473-8601 | |
| (619) 478-2267 |
| Full Name | Mountain Empire School Clinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3291 Buckman Springs Rd, Pine Valley, California |
| Authorized Official Name and Position | Judith Shaplin (CEO) |
| Authorized Official Contact | 6194456200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mountain Empire School Clinic 31115 Highway 94 Campo CA 91906-3133 Ph: (619) 478-5254 | Mountain Empire School Clinic 3291 Buckman Springs Rd Pine Valley CA 91962-4003 Ph: (619) 473-8601 |
| NPI Number | 1326229477 |
|---|---|
| Provider Enumeration Date | 11/16/2007 |
| Last Update Date | 05/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326229477 | NPI | - | NPPES |
| BCP03814F | Other | CA | STATE PROGRAM |
| FHC03814F | Medicaid | CA | |
| HAP03814F | Other | CA | STATE PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000135 (California) | Primary |
Centro De Salud De La Comunidad De San Ysidro Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3291 Buckman Springs Rd, Pine Valley, CA 91962 Phone: 619-662-4100 |