Full Name | |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 480 W 8th St, Gilroy, California |
Authorized Official Name and Position | Jagat Sheth (CHIEF FINANCIAL OFFICER) |
Authorized Official Contact | 5102526810 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
40910 Fremont Blvd Fremont CA 94538-4375 Ph: (510) 770-8040 | 480 W 8th St Gilroy CA 95020-6474 Ph: (408) 337-3221 |
NPI Number | 1316569361 |
---|---|
Provider Enumeration Date | 05/13/2020 |
Last Update Date | 05/07/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1316569361 | NPI | - | NPPES |
1063658029 | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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