| Clinica El Lago Inc | |
|
101 N Palm St Woodlake CA 93286-1422 | |
| (559) 564-1100 | |
| (559) 564-1101 |
| Full Name | Clinica El Lago Inc |
|---|---|
| Speciality | Clinic/center - Rural Health |
| Location | 101 N Palm St, Woodlake, California |
| Authorized Official Name and Position | Mario A Ochoa (OWNER/MEDICAL DIRECTOR) |
| Authorized Official Contact | 5595641100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clinica El Lago Inc 101 N Palm St Woodlake CA 93286-1422 Ph: (559) 564-1100 | Clinica El Lago Inc 101 N Palm St Woodlake CA 93286-1422 Ph: (559) 564-1100 |
| NPI Number | 1386077857 |
|---|---|
| Provider Enumeration Date | 08/19/2013 |
| Last Update Date | 07/21/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386077857 | NPI | - | NPPES |
| 6805241 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | A76417 (California) | Primary |
Clinica Agua Viva-woodlake Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 101 N Palm St, Woodlake, CA 93286 Phone: 559-564-1100 Fax: 559-789-9828 | |
Woodlake Family Health Center Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 180 E Antelope Ave, Woodlake, CA 93286 Phone: 559-564-3538 Fax: 559-564-8411 |