| Kaweah Health Exeter Clinic | |
|
1014 San Juan Ave Exeter CA 93221-1312 | |
| (559) 624-2000 | |
| (559) 713-2356 |
| Full Name | Kaweah Health Exeter Clinic |
|---|---|
| Speciality | Clinic/Center |
| Location | 1014 San Juan Ave, Exeter, California |
| Authorized Official Name and Position | Malinda Tupper (SRVP/CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 5596244065 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kaweah Health Exeter Clinic 400 W Mineral King Ave Visalia CA 93291-6237 Ph: (559) 624-2739 | Kaweah Health Exeter Clinic 1014 San Juan Ave Exeter CA 93221-1312 Ph: (559) 624-2000 |
| NPI Number | 1043272172 |
|---|---|
| Provider Enumeration Date | 04/04/2006 |
| Last Update Date | 04/20/2022 |
| Certification Date | 04/20/2022 |
| Medicare PECOS PAC ID | 6608778790 |
|---|---|
| Medicare Enrollment ID | O20080729000245 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043272172 | NPI | - | NPPES |
| ZZZ54779Z | Other | CA | BLUE SHIELD |
| BCP18508G | Medicaid | CA | |
| HAP18508G | Medicaid | CA | |
| RHM18508G | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | 120000580 (California) | Primary |
| 171M00000X | Case Manager/care Coordinator | (NU) | Secondary |
| 251X00000X | Supports Brokerage | (NU) | Secondary |
San Joaquin Prime Care Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 330 E Pine St, Exeter, CA 93221 Phone: 559-592-2134 Fax: 559-592-5017 |
Rocky Hill Wellness and Aesthetics Nursing Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 216 E Pine St, Exeter, CA 93221 Phone: 559-772-2983 |
Omni Family Health Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 1110 W Visalia Rd Ste 102, Exeter, CA 93221 Phone: 866-707-6664 Fax: 661-746-9197 |
Family Healthcare Network Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 330 E Pine St, Exeter, CA 93221 Phone: 559-737-4700 Fax: 559-734-1247 |
Shyam Bhaskar Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 401 E Maple St, Exeter, CA 93221 Phone: 559-592-6039 Fax: 559-635-7106 |
Rulon Douglas Owen DO Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 244 N Kaweah Ave, Exeter, CA 93221 Phone: 559-592-3889 |