| Bay Area Community Health Irvington Dave Clinic Ii | |
|
40924 Fremont Blvd Fremont CA 94538-4375 | |
| (510) 252-6810 | |
| Not Available |
| Full Name | Bay Area Community Health Irvington Dave Clinic Ii |
|---|---|
| Speciality | Clinic/Center |
| Location | 40924 Fremont Blvd, Fremont, California |
| Authorized Official Name and Position | Jagat Sheth (CFO) |
| Authorized Official Contact | 5102526810 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Area Community Health Irvington Dave Clinic Ii 40910 Fremont Blvd Fremont CA 94538-4375 Ph: (510) 252-6810 | Bay Area Community Health Irvington Dave Clinic Ii 40924 Fremont Blvd Fremont CA 94538-4375 Ph: (510) 252-6810 |
| NPI Number | 1245719129 |
|---|---|
| Provider Enumeration Date | 08/10/2018 |
| Last Update Date | 05/07/2021 |
| Medicare PECOS PAC ID | 1658349824 |
|---|---|
| Medicare Enrollment ID | O20190305002310 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245719129 | NPI | - | NPPES |
| 1780054379 | Medicaid | CA | |
| 550003720 | Other | LICENSE # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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