La Clinica De La Raza Inc in Oakland - Federally Qualified Health Center (fqhc)
La Clinica De La Raza Inc - NPI 1174639116
La Clinica De La Raza Inc is a Federally Qualified Health Center (fqhc) in Oakland, California. La Clinica De La Raza Inc practices all healthcare services and medical treatments related to Federally Qualified Health Center (fqhc). The NPI Number for La Clinica De La Raza Inc is 1174639116. The last update date is 2023-04-21.
La Clinica De La Raza Inc's current location address is 1501 Fruitvale Ave, Oakland, California. You can contact this provider via phone number 5105356200. The mailing address for La Clinica De La Raza Inc is 1501 Fruitvale Ave, Oakland, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | La Clinica De La Raza Inc |
|---|---|
| Address | 1501 Fruitvale Ave, Oakland, California |
| Phone Number | 5105356200 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | CHIEF EXEC |
|---|---|
| Authorized Official Name | Garcia Jane |
| Telephone Number | 5105354000 |
NPI Number Detail
| NPI Number | 1174639116 |
|---|---|
| Provider Enumeration Date | 2006-08-22 |
| Last Updated Date | 2023-04-21 |
Provider Mailing Address Detail
| Address | 1501 Fruitvale Ave |
|---|---|
| City | Oakland |
| State | California (CA) |
| Post Code | 946012322 |
| Phone Number | 5105356200 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Federally Qualified Health Center (fqhc) |
|---|---|
| Taxonomy | 261Qf0400X |
| Licence No | 140000171 |
|
Definition: Provides primary and preventive care services in underserved areas, receiving certain federal funding grants. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| ZZZ29799Z | CA | MEDICARE PART B | |
| 05-1063 | CA | MEDICARE PART A | |
| FHC80040F | CA | -- |
Post Comment/ Review Below
What is the La Clinica De La Raza Inc's 1174639116?
The La Clinica De La Raza Inc's NPI (National Provider Identifier) Number is 1174639116. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where La Clinica De La Raza Inc's facilities are geographically located?
The facilities of La Clinica De La Raza Inc are physically situated at the following location: 1501 Fruitvale Ave, Oakland, CA, 946012322.
What is La Clinica De La Raza Inc's specialized field of practice, and what is the corresponding taxonomy classification code?
The La Clinica De La Raza Inc's area of specialization is Federally Qualified Health Center (fqhc), and the corresponding taxonomy code that categorizes this field of practice is 261Qf0400X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1174639116 to La Clinica De La Raza Inc?
The Centers for Medicare & Medicaid Services originally issued the 1174639116 to La Clinica De La Raza Inc on 2006-08-22.
As of what date were the details pertaining to La Clinica De La Raza Inc last refreshed?
The information related to the La Clinica De La Raza Inc, including its address, specialty, and other relevant details, was last updated on 2023-04-21.