| Lakeside Health Center | |
|
5335 Lakeshore Blvd Lakeport CA 95453-6123 | |
| (707) 263-7725 | |
| Not Available |
| Full Name | Lakeside Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 5335 Lakeshore Blvd, Lakeport, California |
| Authorized Official Name and Position | Tim Dolan (CFO) |
| Authorized Official Contact | 7074672260 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lakeside Health Center 333 Laws Ave Ukiah CA 95482-6540 Ph: (707) 468-1010 | Lakeside Health Center 5335 Lakeshore Blvd Lakeport CA 95453-6123 Ph: (707) 263-7725 |
| NPI Number | 1770516304 |
|---|---|
| Provider Enumeration Date | 07/08/2006 |
| Last Update Date | 05/03/2019 |
| Medicare PECOS PAC ID | 6305755455 |
|---|---|
| Medicare Enrollment ID | O20100616000495 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770516304 | NPI | - | NPPES |
| HAP70845F | Other | CA | FAMILYPACT |
| FHC70845F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 110000350 (California) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Upper Lake Clinic Rhc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-5001 Fax: 707-262-5006 | |
Sutter Lakeside Hospital Mobile Health Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5176 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-5000 Fax: 707-262-5005 | |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 55 1st St, Ste 210, Lakeport, CA 95453 Phone: 707-462-1516 Fax: 707-462-1178 | |
Adventist Health Physicians Network Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 801 11th St, Lakeport, CA 95453 Phone: 707-263-3746 | |
Tribal Health Pediatrics Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 359 Lakeport Blvd, Lakeport, CA 95453 Phone: 707-533-2700 Fax: 707-263-5400 | |
Northern California Medical Assoc Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 5108 Hill Rd E, Lakeport, CA 95453 Phone: 707-262-1840 Fax: 707-262-5844 | |
Sutter Bay Hospitals Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5196 Hill Rd E, Suite 300, Lakeport, CA 95453 Phone: 707-263-6885 Fax: 707-263-6624 |