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2727 W Capitol Ave West Sacramento CA 95691-2220 | |
| (916) 371-2275 | |
| (916) 371-8649 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 2727 W Capitol Ave, West Sacramento, California |
| Authorized Official Name and Position | Alasdair Jonathan Porteus (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 9163138413 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
777 12th St Ste 250 Sacramento CA 95814-1929 Ph: (916) 550-5481 | 2727 W Capitol Ave West Sacramento CA 95691-2220 Ph: (916) 371-2275 |
| NPI Number | 1295293330 |
|---|---|
| Provider Enumeration Date | 03/07/2019 |
| Last Update Date | 03/28/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295293330 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
West Sacramentopediatric Medical Group,inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 1050 Jefferson Blvd, West Sacramento, CA 95691 Phone: 916-371-3787 Fax: 916-371-3790 | |
Live Well Medical Center Inc. Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 515 Michigan Blvd, West Sacramento, CA 95691 Phone: 916-368-0816 | |