| Coastal Health Alliance | |
|
3419 State Route One Stinson Beach CA 94970-0978 | |
| (415) 868-9656 | |
| (415) 868-2858 |
| Full Name | Coastal Health Alliance |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 3419 State Route One, Stinson Beach, California |
| Authorized Official Name and Position | John Severson (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 4156638781 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Coastal Health Alliance Po Box 910 Point Reyes Station CA 94956-0910 Ph: (415) 663-8781 | Coastal Health Alliance 3419 State Route One Stinson Beach CA 94970-0978 Ph: (415) 868-9656 |
| NPI Number | 1255441358 |
|---|---|
| Provider Enumeration Date | 08/30/2006 |
| Last Update Date | 04/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255441358 | NPI | - | NPPES |
| FHC53833F | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 110000413 (California) | Primary |