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General NPI Number Information
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NPI Number | 1841870425
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Entity Type | Organization
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Legal Business Name | SAN JOAQUIN COUNTY CLINICS
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Dates
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Enumeration Date | 04/08/2021
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Last Update Date | 04/08/2021
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Provider Practice Location Address
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Address Line | 500 W HOSPITAL RD STE A
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City | FRENCH CAMP
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State | CA
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Zip | 95231-9693
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Country | US
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Telephone | 209-468-6820
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Fax |
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Provider Business Mailing Address
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Address Line | 500 W HOSPITAL RD STE A
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City | FRENCH CAMP
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State | CA
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Zip | 95231-9693
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Country | US
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Telephone | 209-468-6160
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Fax |
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Authorized Official
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Title or Position | CREDENTIALING SPECIALIST
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Name | MS. CHERON ROBINSON RICE
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Credential |
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Telephone | 209-468-6160
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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