| Valley High School Clinic | |
|
1801 S Greenville St Santa Ana CA 92704-4005 | |
| (714) 446-5100 | |
| Not Available |
| Full Name | Valley High School Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1801 S Greenville St, Santa Ana, California |
| Authorized Official Name and Position | Timothy Jason Brown (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 2088999631 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Valley High School Clinic 731 S Highland Ave Fullerton CA 92832-2753 Ph: (714) 446-5100 | Valley High School Clinic 1801 S Greenville St Santa Ana CA 92704-4005 Ph: (714) 446-5100 |
| NPI Number | 1184092017 |
|---|---|
| Provider Enumeration Date | 09/09/2015 |
| Last Update Date | 06/17/2020 |
| Medicare PECOS PAC ID | 4284886789 |
|---|---|
| Medicare Enrollment ID | O20160105003027 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184092017 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | 550000408 (California) | Primary |
| 261QD0000X | Clinic/center - Dental | 550000408 (California) | Secondary |
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