| Petaluma Health Center, Inc | |
|
1225 N Mcdowell Blvd Petaluma CA 94954-1112 | |
| (707) 559-7500 | |
| Not Available |
| Full Name | Petaluma Health Center, Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1225 N Mcdowell Blvd, Petaluma, California |
| Authorized Official Name and Position | Molly Jouaneh (CFO) |
| Authorized Official Contact | 7075597500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petaluma Health Center, Inc 1455 N Mcdowell Blvd Ste D Petaluma CA 94954-6503 Ph: (707) 559-7500 | Petaluma Health Center, Inc 1225 N Mcdowell Blvd Petaluma CA 94954-1112 Ph: (707) 559-7500 |
| NPI Number | 1275283343 |
|---|---|
| Provider Enumeration Date | 03/24/2022 |
| Last Update Date | 08/30/2022 |
| Medicare PECOS PAC ID | 9133180375 |
|---|---|
| Medicare Enrollment ID | O20220920002073 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275283343 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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