| Vhc At Tully Bcp | |
|
500 Tully Road San Jose CA 95111-1917 | |
| (408) 885-5000 | |
| Not Available |
| Full Name | Vhc At Tully Bcp |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 500 Tully Road, San Jose, California |
| Authorized Official Name and Position | Paul E Lorenz (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 4088854010 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Vhc At Tully Bcp Po Box 103331 Pasadena CA 91189-3331 Ph: (669) 299-8165 | Vhc At Tully Bcp 500 Tully Road San Jose CA 95111-1917 Ph: (408) 885-5000 |
| NPI Number | 1730358979 |
|---|---|
| Provider Enumeration Date | 02/21/2008 |
| Last Update Date | 10/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730358979 | NPI | - | NPPES |
| BCP80070F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 070000085 (California) | Primary |
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