| Golden Valley Health Center | |
|
13161 Jefferson St Le Grand CA 95333-9766 | |
| (209) 389-1900 | |
| (209) 389-1907 |
| Full Name | Golden Valley Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 13161 Jefferson St, Le Grand, California |
| Authorized Official Name and Position | Tony Weber (CEO) |
| Authorized Official Contact | 2093846493 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Golden Valley Health Center 737 W Childs Ave Merced CA 95341-6805 Ph: (209) 384-6493 | Golden Valley Health Center 13161 Jefferson St Le Grand CA 95333-9766 Ph: (209) 389-1900 |
| NPI Number | 1356325310 |
|---|---|
| Provider Enumeration Date | 12/02/2005 |
| Last Update Date | 02/09/2017 |
| Medicare PECOS PAC ID | 4183527187 |
|---|---|
| Medicare Enrollment ID | O20111109000162 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356325310 | NPI | - | NPPES |
| CMM71050F | Medicaid | CA | |
| 040000373 | Other | CA | STATE OF CA LIC# |
| ZZZ52122Z | Other | CA | BLUE SHIELD OF CA GRP PIN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 040000373 (California) | Primary |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13161 Jefferson St, Le Grand, CA 95333 Phone: 209-389-1900 | |
Golden Valley Health Centers Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13162 Jefferson St, Le Grand, CA 95333 Phone: 209-389-1900 Fax: 209-384-3966 |