Basic Information
| Provider Information | |||||||||
| NPI: | 1285843128 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 790 | ||||||||
| Address2: | |||||||||
| City: | PARLIER | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936480790 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5596463561 | ||||||||
| FaxNumber: | 5596463642 | ||||||||
| Practice Location | |||||||||
| Address1: | 517 S MADERA AVE | ||||||||
| Address2: | |||||||||
| City: | KERMAN | ||||||||
| State: | CA | ||||||||
| PostalCode: | 936301523 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5598466330 | ||||||||
| FaxNumber: | 5598465553 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/21/2007 | ||||||||
| LastUpdateDate: | 06/04/2010 | ||||||||
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| AuthorizedOfficialLastName: | CURTIS | ||||||||
| AuthorizedOfficialFirstName: | COLLEEN | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 5596466618 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | 040000380 | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.