| Indian Health Center Of Santa Clara Valley | |
|
25 N 14th St Ste 140 San Jose CA 95112-6218 | |
| (408) 445-3400 | |
| (408) 448-1727 |
| Full Name | Indian Health Center Of Santa Clara Valley |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 25 N 14th St Ste 140, San Jose, California |
| Authorized Official Name and Position | Aldon Wayne Scott (DIRECTOR OF OPERATIONS) |
| Authorized Official Contact | 4084453400 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Indian Health Center Of Santa Clara Valley 1333 Meridian Ave San Jose CA 95125-5212 Ph: (408) 445-3400 | Indian Health Center Of Santa Clara Valley 25 N 14th St Ste 140 San Jose CA 95112-6218 Ph: (408) 445-3400 |
| NPI Number | 1538529052 |
|---|---|
| Provider Enumeration Date | 02/25/2016 |
| Last Update Date | 02/25/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1538529052 | NPI | - | NPPES |
| FHC11833F | Medicaid | CA | |
| FHC11833F | Other | CA | MEDI-CAL |
| 55-1137 | Other | CA | MEDICARE PALMETTO |
| FHC11833F | Other | CA | STATE PROGRAM |
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