| Southern Indian Health Council Inc | |
|
Viejas Outlet Center-medical Offices 5005 Willows Road Suite J-111 Alpine CA 91901-9190 | |
| (619) 445-1188 | |
| Not Available |
| Full Name | Southern Indian Health Council Inc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | Viejas Outlet Center-medical Offices, Alpine, California |
| Authorized Official Name and Position | Marie Dizon (LEAD BILLER) |
| Authorized Official Contact | 6194451188 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Indian Health Council Inc Viejas Outlet Center - Medical Offices 5005 Willows Road Suite J-111 Alpine CA 91901 Ph: (619) 445-1188 | Southern Indian Health Council Inc Viejas Outlet Center-medical Offices 5005 Willows Road Suite J-111 Alpine CA 91901-9190 Ph: (619) 445-1188 |
| NPI Number | 1295491736 |
|---|---|
| Provider Enumeration Date | 11/09/2021 |
| Last Update Date | 11/09/2021 |
| Certification Date | 10/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295491736 | NPI | - | NPPES |
| THP70010F | Medicaid | CA | |
| W7576A | Other | CA | MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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