Healthcare Provider Details

I. General information

NPI: 1225395940
Provider Name (Legal Business Name): SALUD PARA LA GENTE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2012
Last Update Date: 05/17/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 WALNUT AVE
GREENFIELD CA
93927-4938
US

IV. Provider business mailing address

195 AVIATION WAY SUITE 200
WATSONVILLE CA
95076-2053
US

V. Phone/Fax

Practice location:
  • Phone: 831-728-8250
  • Fax: 831-728-0313
Mailing address:
  • Phone: 831-422-6889
  • Fax: 831-728-0313

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: MR. CARLOS R GARCIA
Title or Position: CFO
Credential:
Phone: 831-728-8250