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General NPI Number Information
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NPI Number | 1801685193
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Entity Type | Organization
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Legal Business Name | LA CLINICA DE LA RAZA INC
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Dates
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Enumeration Date | 05/02/2025
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Last Update Date | 05/02/2025
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Provider Practice Location Address
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Address Line | 9475 INTERNATIONAL BLVD
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City | OAKLAND
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State | CA
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Zip | 94603-1443
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Country | US
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Telephone | 510-434-5770
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Fax | 510-434-5790
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Provider Business Mailing Address
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Address Line | PO BOX 22210
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City | OAKLAND
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State | CA
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Zip | 94623-2210
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | KANWAR SINGH
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Credential |
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Telephone | 510-535-2915
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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