St. Jude Neighborhood Health Centers | |
725 W La Veta Ave Ste 260 Orange CA 92868-4439 | |
(714) 771-8006 | |
(714) 774-8630 |
Full Name | St. Jude Neighborhood Health Centers |
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Speciality | Clinic/Center |
Location | 725 W La Veta Ave Ste 260, Orange, California |
Authorized Official Name and Position | Timothy Jason Brown (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 7144465230 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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St. Jude Neighborhood Health Centers 731 S Highland Ave Fullerton CA 92832-2753 Ph: (714) 446-5100 | St. Jude Neighborhood Health Centers 725 W La Veta Ave Ste 260 Orange CA 92868-4439 Ph: (714) 771-8006 |
NPI Number | 1235627563 |
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Provider Enumeration Date | 04/23/2018 |
Last Update Date | 06/17/2020 |
Medicare PECOS PAC ID | 4284886789 |
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Medicare Enrollment ID | O20180918004235 |
Identifier | Type | State | Issuer |
---|---|---|---|
1235627563 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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