MEDICARE: UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QF0400X	Federally Qualified Health Center (FQHC)

General Provider Information

NPI Number	:	1497150593
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY

Provider Business Mailing Address
First Line	:	PO BOX 69
Second Line	:
City	:	RAISIN CITY
State	:	CA
Zip	:	93652-0069
Country	:	US
Telephone Number	:	559-233-0111
Fax Number	:	559-233-0112

Provider Business Practice Location Address
First Line	:	6425 W BOWLES
Second Line	:
City	:	RAISIN CITY
State	:	CA
Zip	:	93652-0069
Country	:	US
Telephone Number	:	559-233-0111
Fax Number	:	559-233-0112

Authorized Official
Title or Position	:	CEO
Name	:	MS. COLLEEN CURTIS
Credential	:
Telephone Number	:	559-646-6618

Provider Enumeration Date	:	10/31/2014
Last Update Date	:	10/31/2014

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Directions to “UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY ” Practice Location

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