MEDICARE: PATTERSON 1ST CARE CLINIC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QR1300X	Rural Health Clinic/Center	G44829	CA

General Provider Information

NPI Number	:	1538603063
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PATTERSON 1ST CARE CLINIC

Provider Business Mailing Address
First Line	:	101 N 3RD ST
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-2501
Country	:	US
Telephone Number	:	209-892-1400
Fax Number	:	209-892-7993

Provider Business Practice Location Address
First Line	:	101 N 3RD ST
Second Line	:
City	:	PATTERSON
State	:	CA
Zip	:	95363-2501
Country	:	US
Telephone Number	:	209-892-1400
Fax Number	:	209-892-7993

Authorized Official
Title or Position	:	OWNER
Name	:	MICHAEL SCHORR
Credential	:	MD
Telephone Number	:	209-892-1400

Provider Enumeration Date	:	12/19/2016
Last Update Date	:	12/19/2016

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Directions to “PATTERSON 1ST CARE CLINIC ” Practice Location

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