| Petaluma Health Center Inc | |
|
5900 State Farm Dr Rohnert Park CA 94928-2149 | |
| (707) 559-7500 | |
| (707) 559-7620 |
| Full Name | Petaluma Health Center Inc |
|---|---|
| Speciality | Clinic/Center |
| Location | 5900 State Farm Dr, Rohnert Park, California |
| Authorized Official Name and Position | Pedro Toledo (INTERIM CEO) |
| Authorized Official Contact | 7075597692 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Petaluma Health Center Inc 1179 N Mcdowell Blvd Petaluma CA 94954-6559 Ph: () - | Petaluma Health Center Inc 5900 State Farm Dr Rohnert Park CA 94928-2149 Ph: (707) 559-7500 |
| NPI Number | 1669870739 |
|---|---|
| Provider Enumeration Date | 12/05/2014 |
| Last Update Date | 03/24/2022 |
| Medicare PECOS PAC ID | 9133180375 |
|---|---|
| Medicare Enrollment ID | O20160330002260 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669870739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 110000313 (California) | Primary |
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