GOLDEN VALLEY HEALTH CENTER NPI 1336123926

NPI Information

NPI: 1336123926
Provider Name: GOLDEN VALLEY HEALTH CENTER
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
1510 FLORIDA AVE
SUITE H
MODESTO, CA
ZIP 95350
Phone: (209) 574-1030
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GOLDEN VALLEY HEALTH CENTER is a federally qualified health center (fqhc) clinic center in Modesto, CA. GOLDEN VALLEY HEALTH CENTER NPI is 1336123926. The provider is registered as an organization entity type.

The provider's business location address is:

1510 FLORIDA AVE
SUITE H
MODESTO, CA
ZIP 95350-437
Phone: (209) 574-1030
Fax: (209) 574-1038

The provider's authorized official is Tony Weber .
The authorized official title is Ceo and has the following contact phone number (209) 384-6493.

The enumeration date for this NPI number is 12/6/2005 and was last updated on 2/9/2017.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	030000554	CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	030000554	OTHER	CALIFORNIA	STATE OF CA LIC#
2	FHC70634F	OTHER	CALIFORNIA	FQHC#
3	ZZZ01280Z	MEDICARE PIN	CALIFORNIA
4	CMM70634F	OTHER	CALIFORNIA	CMM#
5	ZZZ52118Z	OTHER	CALIFORNIA	BLUE SHIELD OF CA GRP PIN
6	GR008628A	MEDICAID	CALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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