| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 451 Mesa Road, Bolinas, California |
| Authorized Official Name and Position | Steven P Siegel (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4156638781 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 910 Point Reyes Station CA 94956-0910 Ph: (415) 663-8781 | 451 Mesa Road Bolinas CA 94924 Ph: (415) 663-8666 |
| NPI Number | 1922499979 |
|---|---|
| Provider Enumeration Date | 02/12/2015 |
| Last Update Date | 02/12/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1922499979 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (California) | Primary |