| Barstow Indian Health | |
|
170 Yucca Ave Barstow CA 92311-3231 | |
| (760) 256-9016 | |
| (760) 256-7856 |
| Full Name | Barstow Indian Health |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 170 Yucca Ave, Barstow, California |
| Authorized Official Name and Position | William Thomsen (CEO) |
| Authorized Official Contact | 9098641097 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Barstow Indian Health 11980 Mount Vernon Ave Grand Terrace CA 92313-5172 Ph: (909) 864-1097 | Barstow Indian Health 170 Yucca Ave Barstow CA 92311-3231 Ph: (760) 256-9016 |
| NPI Number | 1134621923 |
|---|---|
| Provider Enumeration Date | 03/07/2018 |
| Last Update Date | 08/25/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134621923 | NPI | - | NPPES |
| 1720178478 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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