| Mcdph Dpp | |
|
1604 Sunrise Ave Madera CA 93638-4926 | |
| (559) 675-7893 | |
| Not Available |
| Full Name | Mcdph Dpp |
|---|---|
| Speciality | Clinic/center - Public Health, State Or Local |
| Location | 1604 Sunrise Ave, Madera, California |
| Authorized Official Name and Position | Sean Kirkpatrick (DEPUTY PH DIRECTOR - OPERATIONS) |
| Authorized Official Contact | 5596757893 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcdph Dpp 1604 Sunrise Ave Madera CA 93638-4926 Ph: (559) 675-7893 | Mcdph Dpp 1604 Sunrise Ave Madera CA 93638-4926 Ph: (559) 675-7893 |
| NPI Number | 1114637873 |
|---|---|
| Provider Enumeration Date | 12/02/2022 |
| Last Update Date | 12/02/2022 |
| Certification Date | 11/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1114637873 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP0905X | Clinic/center - Public Health, State Or Local | (NU) | Primary |
| 174H00000X | Health Educator | (NU) | Secondary |
| 171400000X | Health & Wellness Coach | (NU) | Secondary |
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