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3314 Fong Ranch Rd Sacramento CA 95834 | |
| (916) 642-1867 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3314 Fong Ranch Rd, Sacramento, California |
| Authorized Official Name and Position | Jerry T Bliatout (CEO) |
| Authorized Official Contact | 9166421867 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
3030 Explorer Dr Sacramento CA 95827-2728 Ph: (916) 642-1867 | 3314 Fong Ranch Rd Sacramento CA 95834 Ph: (916) 642-1867 |
| NPI Number | 1427808310 |
|---|---|
| Provider Enumeration Date | 03/25/2024 |
| Last Update Date | 11/21/2024 |
| Certification Date | 11/21/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427808310 | NPI | - | NPPES |
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