| St. Jude Mobile Health Clinic 1 | |
|
731 South Highland Avenue Fullerton CA 92832 | |
| (714) 446-5100 | |
| Not Available |
| Full Name | St. Jude Mobile Health Clinic 1 |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 731 South Highland Avenue, Fullerton, California |
| Authorized Official Name and Position | Barry Ross (VICE PRESIDENT, HEALTHY COMMUNITIES) |
| Authorized Official Contact | 7149923164 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Jude Mobile Health Clinic 1 731 South Highland Avenue Fullerton CA 92832 Ph: (714) 446-5100 | St. Jude Mobile Health Clinic 1 731 South Highland Avenue Fullerton CA 92832 Ph: (714) 446-5100 |
| NPI Number | 1386869907 |
|---|---|
| Provider Enumeration Date | 04/17/2007 |
| Last Update Date | 02/27/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386869907 | NPI | - | NPPES |
| CMM70906F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 70906F (California) | Primary |
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