| Techniclinic | |
|
4351 Broadway Oakland CA 94611-4612 | |
| (510) 879-1907 | |
| (510) 879-1999 |
| Full Name | Techniclinic |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 4351 Broadway, Oakland, California |
| Authorized Official Name and Position | Jane Garcia (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5105354000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Techniclinic Po Box 22210 Oakland CA 94623-2210 Ph: (510) 535-4000 | Techniclinic 4351 Broadway Oakland CA 94611-4612 Ph: (510) 879-1907 |
| NPI Number | 1013085778 |
|---|---|
| Provider Enumeration Date | 12/01/2006 |
| Last Update Date | 04/30/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013085778 | NPI | - | NPPES |
| 05-1821 | Other | CA | MEDICARE PART A |
| HAP71125F | Other | CA | FPACT |
| FHC71125F | Medicaid | CA | |
| ZZZ2118Z | Other | CA | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550000169 (California) | Primary |
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Secondary |
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