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2401 W Turner Rd Lodi CA 95242-2182 | |
(209) 370-1700 | |
(209) 370-1737 |
Full Name | |
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Speciality | Clinic/Center |
Location | 2401 W Turner Rd, Lodi, California |
Authorized Official Name and Position | Michael H Kirkpatrick (CEO) |
Authorized Official Contact | 2093732833 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Po Box 779 Stockton CA 95201-0779 Ph: (209) 373-2800 | 2401 W Turner Rd Lodi CA 95242-2182 Ph: (209) 370-1700 |
NPI Number | 1881685964 |
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Provider Enumeration Date | 10/28/2005 |
Last Update Date | 07/14/2010 |
Medicare PECOS PAC ID | 8426968520 |
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Medicare Enrollment ID | O20100803000991 |
Identifier | Type | State | Issuer |
---|---|---|---|
1881685964 | NPI | - | NPPES |
FHC70460F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
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261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 030000424 (California) | Primary |
Inpatient Services Of California, Inc., A Medical Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 975 S. Fairmont Ave, Lodi, CA 95240 Phone: 214-712-2400 |