| Southern Indian Health Council Inc | |
|
4058 Willows Rd Alpine CA 91901-1668 | |
| (619) 445-1188 | |
| (619) 659-3140 |
| Full Name | Southern Indian Health Council Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4058 Willows Rd, Alpine, California |
| Authorized Official Name and Position | Terrance A King (CFO) |
| Authorized Official Contact | 6194451188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Indian Health Council Inc 4058 Willows Road Alpine CA 91901-1668 Ph: (619) 445-1188 | Southern Indian Health Council Inc 4058 Willows Rd Alpine CA 91901-1668 Ph: (619) 445-1188 |
| NPI Number | 1346247947 |
|---|---|
| Provider Enumeration Date | 06/28/2005 |
| Last Update Date | 10/04/2017 |
| Medicare PECOS PAC ID | 9830221449 |
|---|---|
| Medicare Enrollment ID | O20121003000573 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1346247947 | NPI | - | NPPES |
| ZZZ58086Z | Other | BLUE SHIELD OF CALIFORNIA | |
| THP70010F | Medicaid | CA | |
| HAP70010F | Other | CA | FAMILY PACT |
| W7576A | Other | CA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (California) | Primary |
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