| |
835 Webster St Oakland CA 94607-4219 | |
(510) 318-5800 | |
(510) 986-8681 |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 835 Webster St, Oakland, California |
Authorized Official Name and Position | John Chiang (CFO) |
Authorized Official Contact | 5109866830 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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835 Webster St Oakland CA 94607-4219 Ph: (510) 318-5800 | 835 Webster St Oakland CA 94607-4219 Ph: (510) 318-5800 |
NPI Number | 1225179641 |
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Provider Enumeration Date | 02/09/2007 |
Last Update Date | 09/17/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1225179641 | NPI | - | NPPES |
551800 | Other | CA | MEDICARE PTAN NUMBER |
1689744179 | Other | CA | MEDICARE NPI NUMBER |
FHC70686F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 14000053 (California) | Primary |
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