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Mendocino Community Health Clinic, Inc.
Federally Qualified Health Center (FQHC) in Lakeport, California
NPI 1770516304

Mendocino Community Health Clinic, Inc. is a Federally Qualified Health Center (FQHC) based in Ukiah, CA and is specialized in Federally Qualified Health Center (FQHC). Mendocino Community Health Clinic, Inc. practices in Lakeport, CA. The NPI Number for Mendocino Community Health Clinic, Inc. is 1770516304 and holds a License No. 110000350 (California).

The current practice location address for Mendocino Community Health Clinic, Inc. is 5335 Lakeshore Blvd, Lakeport, CA and can be reached out via phone at 707-263-7725.

Location: 5335 Lakeshore Blvd, Lakeport, CA, 95482-6540
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1770516304
Provider Name
Mendocino Community Health Clinic, Inc.
Credential
Provider Entity Type
Organization
Address
5335 Lakeshore Blvd, Lakeport, CA, 95482-6540
Phone Number
707-263-7725
Fax Number
Provider Enumeration Date
07/08/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
HAP70845F 01 CA FAMILYPACT
FHC70845F 05 CA
institution
Provider Business Practice Location Address Details
Address
5335 Lakeshore Blvd
City
Lakeport
State
California
Zip
95453-6123
Phone Number
707-263-7725
Fax Number
person
Provider Business Mailing Address Details
Address
5335 Lakeshore Blvd
City
Lakeport
State
California
Zip
95453-6123
Phone Number
707-263-7725
Fax Number
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
-
Taxonomy
261Q00000X
License No.
()
Definition
A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health).
person
Provider's Taxonomy Details 2
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Federally Qualified Health Center (FQHC)
Taxonomy
261QF0400X
License No.
110000350 (California)
Definition
Definition to come...
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