| Community Medical Centers, Tusd Student Wellness Center | |
|
164 W Grant Line Rd Bldg Portable Office Room 8 Tracy CA 95376-2614 | |
| (209) 650-4000 | |
| Not Available |
| Full Name | Community Medical Centers, Tusd Student Wellness Center |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 164 W Grant Line Rd Bldg Portable Office Room 8, Tracy, California |
| Authorized Official Name and Position | Christine Noguera (CEO) |
| Authorized Official Contact | 2093732831 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Community Medical Centers, Tusd Student Wellness Center 7210 Murray Dr Stockton CA 95210-3339 Ph: (209) 373-2800 | Community Medical Centers, Tusd Student Wellness Center 164 W Grant Line Rd Bldg Portable Office Room 8 Tracy CA 95376-2614 Ph: (209) 650-4000 |
| NPI Number | 1972283745 |
|---|---|
| Provider Enumeration Date | 07/18/2023 |
| Last Update Date | 07/18/2023 |
| Certification Date | 07/13/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972283745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | () | Primary |
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