| La Clinica De La Raza Inc | |
|
1501 Fruitvale Ave Oakland CA 94601-2322 | |
| (510) 535-6200 | |
| Not Available |
| Full Name | La Clinica De La Raza Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1501 Fruitvale Ave, Oakland, California |
| Authorized Official Name and Position | Jane Garcia (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 5105354000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| La Clinica De La Raza Inc Po Box 22210 Oakland CA 94623-2210 Ph: (510) 535-4000 | La Clinica De La Raza Inc 1501 Fruitvale Ave Oakland CA 94601-2322 Ph: (510) 535-6200 |
| NPI Number | 1174639116 |
|---|---|
| Provider Enumeration Date | 08/22/2006 |
| Last Update Date | 04/21/2023 |
| Certification Date | 04/21/2023 |
| Medicare PECOS PAC ID | 1557258282 |
|---|---|
| Medicare Enrollment ID | O20061031000587 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174639116 | NPI | - | NPPES |
| ZZZ29799Z | Other | CA | MEDICARE PART B |
| 05-1063 | Other | CA | MEDICARE PART A |
| FHC80040F | Medicaid | CA |
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