| Bay Area Community Health - Main Street Village | |
|
3607 Main St Ste B Fremont CA 94538-4390 | |
| (510) 770-8040 | |
| (510) 623-8926 |
| Full Name | Bay Area Community Health - Main Street Village |
|---|---|
| Speciality | Clinic/Center |
| Location | 3607 Main St Ste B, Fremont, California |
| Authorized Official Name and Position | Zettie D Page (CEO) |
| Authorized Official Contact | 5102526811 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bay Area Community Health - Main Street Village 40910 Fremont Blvd Fremont CA 94538-4375 Ph: (510) 770-8040 | Bay Area Community Health - Main Street Village 3607 Main St Ste B Fremont CA 94538-4390 Ph: (510) 770-8040 |
| NPI Number | 1497021109 |
|---|---|
| Provider Enumeration Date | 03/27/2012 |
| Last Update Date | 05/07/2021 |
| Medicare PECOS PAC ID | 1658349824 |
|---|---|
| Medicare Enrollment ID | O20150730011054 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497021109 | NPI | - | NPPES |
| 550002016 | Other | CA | CLINIC LICENSE |
| 1497021109 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550002016 (California) | Primary |
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