| Petaluma Health Center Inc | |
|
3 Sixth Street Point Reyes Station CA 94956-0910 | |
| (415) 663-8666 | |
| (415) 663-9532 |
| Full Name | Petaluma Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 3 Sixth Street, Point Reyes Station, 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 3 Sixth Street Point Reyes Station CA 94956-0910 Ph: (415) 663-8666 |
| NPI Number | 1053420844 |
|---|---|
| Provider Enumeration Date | 08/29/2006 |
| Last Update Date | 06/08/2021 |
| Medicare PECOS PAC ID | 9133180375 |
|---|---|
| Medicare Enrollment ID | O20200827001659 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053420844 | NPI | - | NPPES |
| BCP70434F | Medicaid | CA | |
| HAP70434F | Medicaid | CA | |
| FHC70434F | Medicaid | CA | |
| EAP70434F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 110000399 (California) | Primary |
Marin Healthcare District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11150 Highway 1, Point Reyes Station, CA 94956 Phone: 415-663-1082 Fax: 415-663-9474 | |
Coastal Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 503 B Street, Point Reyes Station, CA 94956 Phone: 415-663-8666 Fax: 415-663-9532 | |
Colin Hamblin, A Professional Medical Corporation Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 11150 Highway 1, Point Reyes Station, CA 94956 Phone: 415-663-1082 Fax: 415-663-9474 | |
Coastal Health Alliance Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 65 Third Street, Suite 17, Point Reyes Station, CA 94956 Phone: 415-663-8781 Fax: 415-663-9630 |