| La Clinica Pittsburg Dental | |
|
339 E Leland Rd Pittsburg CA 94565-4911 | |
| (925) 431-1250 | |
| (925) 431-1252 |
| Full Name | La Clinica Pittsburg Dental |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 339 E Leland Rd, Pittsburg, California |
| Authorized Official Name and Position | Jane Garcia (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5105354000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| La Clinica Pittsburg Dental 1601 Fruitvale Ave Oakland CA 94601-2322 Ph: (510) 535-4000 | La Clinica Pittsburg Dental 339 E Leland Rd Pittsburg CA 94565-4911 Ph: (925) 431-1250 |
| NPI Number | 1528080470 |
|---|---|
| Provider Enumeration Date | 07/23/2006 |
| Last Update Date | 10/29/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528080470 | NPI | - | NPPES |
| FHC70833F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (California) | Primary |
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