Healthcare Provider Details

I. General information

NPI: 1316868649
Provider Name (Legal Business Name): SOLEDAD COMMUNITY HEALTH CARE DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600B MAIN ST
SOLEDAD CA
93960-2533
US

IV. Provider business mailing address

612 MAIN ST
SOLEDAD CA
93960-2533
US

V. Phone/Fax

Practice location:
  • Phone: 831-678-2462
  • Fax: 831-678-2020
Mailing address:
  • Phone: 831-678-2462
  • Fax: 831-678-1539

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: IDA LOPEZ CHAN
Title or Position: CHIEF EXECUTIVE OFFICER
Credential:
Phone: 831-678-2462