institution
La Clinica De La Raza Inc
Student Health Clinic/Center in Oakland, California
NPI 1013085778

La Clinica De La Raza Inc is a Student Health Clinic/Center based in Oakland, CA and is specialized in Student Health. La Clinica De La Raza Inc practices in Oakland, CA. The NPI Number for La Clinica De La Raza Inc is 1013085778 and holds a License No. 550000169 (California).

The current practice location address for La Clinica De La Raza Inc is 4351 Broadway, Oakland, CA and can be reached out via phone at 510-879-1907 and via fax at 510-879-1999.

Location: 4351 Broadway, Oakland, CA, 94623-2210
institution
Provider Profile Details
NPI Number
1013085778
Provider Name
La Clinica De La Raza Inc
Credential
Provider Entity Type
Organization
Address
4351 Broadway, Oakland, CA, 94623-2210
Phone Number
510-879-1907
Fax Number
510-879-1999
Provider Enumeration Date
12/01/2006
Last Update Date
05/18/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
05-1821 01 CA MEDICARE PART A
HAP71125F 01 CA FPACT
FHC71125F 05 CA
ZZZ2118Z 01 CA MEDICARE PART B
institution
Provider Business Practice Location Address Details
Address
4351 Broadway
City
State
Zip
94611-4612
Phone Number
510-879-1907
Fax Number
510-879-1999
person
Provider Business Mailing Address Details
Address
4351 Broadway
City
State
Zip
94611-4612
Phone Number
510-879-1907
Fax Number
510-879-1999
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
License No.
()
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Student Health
Taxonomy
License No.
550000169 (California)
Definition
Definition to come...
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