Full Name | |
---|---|
Speciality | Clinic/Center |
Location | 835 Webster St, Oakland, California |
Authorized Official Name and Position | Alma Olaguer (PFS MANAGER) |
Authorized Official Contact | 5107353980 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
101 8th St Ste 100 Oakland CA 94607-4707 Ph: (510) 735-3100 | 835 Webster St Oakland CA 94607 Ph: (510) 318-5800 |
NPI Number | 1689744179 |
---|---|
Provider Enumeration Date | 11/09/2006 |
Last Update Date | 08/21/2018 |
Medicare PECOS PAC ID | 0244271021 |
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Medicare Enrollment ID | O20100812000405 |
Identifier | Type | State | Issuer |
---|---|---|---|
1689744179 | NPI | - | NPPES |
1225179641 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 140000532 (California) | Primary |
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