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General NPI Number Information
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NPI Number | 1841525862
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Entity Type | Organization
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Legal Business Name | FAMILY HEALTH MEDICAL CENTER INC.
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Dates
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Enumeration Date | 10/08/2009
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 1045 5TH ST
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City | LOS BANOS
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State | CA
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Zip | 93635-4204
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Country | US
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Telephone | 209-827-4747
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Fax | 209-827-5831
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Provider Business Mailing Address
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Address Line | 1045 5TH ST
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City | LOS BANOS
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State | CA
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Zip | 93635-4204
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Country | US
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Telephone | 209-827-4747
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Fax | 209-827-5831
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | MOHAMMED AL-HASAN
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Credential | M.D.
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Telephone | 209-827-4747
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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 | G74536
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License Number State | CA
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