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General NPI Number Information
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NPI Number | 1003822453
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Entity Type | Organization
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Legal Business Name | SOLEDAD COMMUNITY HEALTH CARE DISTRICT
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 600 MAIN ST
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City | SOLEDAD
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State | CA
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Zip | 93960-2533
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Country | US
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Telephone | 831-678-2462
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Fax | 831-678-1539
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Provider Business Mailing Address
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Address Line | 612 MAIN ST
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City | SOLEDAD
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State | CA
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Zip | 93960-2533
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Country | US
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Telephone | 831-678-2462
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Fax | 831-678-1539
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | IDA LOPEZ CHAN
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Credential |
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Telephone | 831-678-2462
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number | 070000327
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License Number State | CA
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