Basic Information
| Provider Information | |||||||||
| NPI: | 1427330869 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COUNTY OF SOLANO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 275 BECK AVE # MS 5215 | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945336804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077848575 | ||||||||
| FaxNumber: | 7074876759 | ||||||||
| Practice Location | |||||||||
| Address1: | 2201 COURAGE DR | ||||||||
| Address2: | |||||||||
| City: | FAIRFIELD | ||||||||
| State: | CA | ||||||||
| PostalCode: | 945336733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7077842010 | ||||||||
| FaxNumber: | 7077842032 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/12/2011 | ||||||||
| LastUpdateDate: | 11/23/2015 | ||||||||
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| AuthorizedOfficialLastName: | LAPIRA | ||||||||
| AuthorizedOfficialFirstName: | MARIA | ||||||||
| AuthorizedOfficialMiddleName: | TERESA L | ||||||||
| AuthorizedOfficialTitleorPosition: | HS&S FINANCIAL MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 7077848400 | ||||||||
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| IsOrganizationSubpart: | Y | ||||||||
| ParentOrganizationLBN: | COUNTY OF SOLANO | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QF0400X | CA | Y | Ambulatory Health Care Facilities | Clinic/Center | Federally Qualified Health Center (FQHC) |
No ID Information.