| Tri-state Community Healthcare Center | |
|
11499 Bartlett Ave Adelanto CA 92301-1902 | |
| (760) 444-4258 | |
| Not Available |
| Full Name | Tri-state Community Healthcare Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 11499 Bartlett Ave, Adelanto, California |
| Authorized Official Name and Position | Crystale Mineros (CREDENTIALING MANAGER) |
| Authorized Official Contact | 9095757161 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Tri-state Community Healthcare Center 1535 E Colorado St Glendale CA 91205-1513 Ph: () - | Tri-state Community Healthcare Center 11499 Bartlett Ave Adelanto CA 92301-1902 Ph: (760) 444-4258 |
| NPI Number | 1508379017 |
|---|---|
| Provider Enumeration Date | 11/07/2017 |
| Last Update Date | 03/13/2024 |
| Medicare PECOS PAC ID | 5597991968 |
|---|---|
| Medicare Enrollment ID | O20180418002336 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508379017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
Molina Healthcare Of Californa Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11965 Cactus Rd, Adelanto, CA 92301 Phone: 760-561-6081 Fax: 877-778-9461 | |
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