Morongo Indian Health Clinic | |
11555 Potrero Rd Banning CA 92220-6946 | |
(951) 849-4761 | |
(951) 849-5612 |
Full Name | Morongo Indian Health Clinic |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 11555 Potrero Rd, Banning, California |
Authorized Official Name and Position | Linwood J. Killam (CEO) |
Authorized Official Contact | 9518494761 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Morongo Indian Health Clinic 11555 Potrero Rd Banning CA 92220-6946 Ph: (951) 849-4761 | Morongo Indian Health Clinic 11555 Potrero Rd Banning CA 92220-6946 Ph: (951) 849-4761 |
NPI Number | 1841417300 |
---|---|
Provider Enumeration Date | 04/19/2007 |
Last Update Date | 08/22/2020 |
Identifier | Type | State | Issuer |
---|---|---|---|
1841417300 | NPI | - | NPPES |
EAPC03854F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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