COMMUNITY MEDICAL CENTERS INC. NPI 1457621922

NPI Information

NPI: 1457621922
Provider Name: COMMUNITY MEDICAL CENTERS, INC.
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 05D0063425

Address:
200 COTTAGE AVE STE 103
MANTECA, CA
ZIP 95336
Phone: (209) 624-5800
Get Directions

COMMUNITY MEDICAL CENTERS, INC. is a federally qualified health center (fqhc) clinic center in Manteca, CA. COMMUNITY MEDICAL CENTERS, INC. NPI is 1457621922. The provider is registered as an organization entity type.

The provider's business location address is:

200 COTTAGE AVE STE 103
MANTECA, CA
ZIP 95336-935
Phone: (209) 624-5800
Fax: (209) 624-5801

The provider's authorized official is Michelle Renee Bagalayos .
The authorized official title is Director Of Finance and has the following contact phone number (209) 373-2838.

The CLIA number assigned to this NPI record is 05D0063425 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 12/30/2011 and was last updated on 12/30/2011.

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)	550000238	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	551031	MEDICARE PIN	CALIFORNIA
2	1710211214	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: 5/5/2024

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

« Previous NPI

Next NPI »