Healthcare Provider Details

I. General information

NPI: 1518806785
Provider Name (Legal Business Name): LIFELONG MEDICAL CARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/25/2026
Last Update Date: 03/26/2026
Certification Date: 03/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 MCKAY AVE STE B
ALAMEDA CA
94501-7806
US

IV. Provider business mailing address

1245 MCKAY AVE STE B
ALAMEDA CA
94501-7806
US

V. Phone/Fax

Practice location:
  • Phone: 510-847-4348
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: AMY HATFIELD
Title or Position: DIRECTOR PATIENT ACCOUNTS
Credential:
Phone: 916-749-6192