Soboba Indian Health Clinic | |
23119 Soboba Way San Jacinto CA 92583-5517 | |
(951) 654-0803 | |
(951) 654-9387 |
Full Name | Soboba Indian Health Clinic |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 23119 Soboba Way, San Jacinto, California |
Authorized Official Name and Position | William Thomsen (CEO) |
Authorized Official Contact | 9098641097 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Soboba Indian Health Clinic 11980 Mount Vernon Ave Grand Terrace CA 92313-5172 Ph: (909) 864-1097 | Soboba Indian Health Clinic 23119 Soboba Way San Jacinto CA 92583-5517 Ph: (951) 654-0803 |
NPI Number | 1386837227 |
---|---|
Provider Enumeration Date | 08/23/2007 |
Last Update Date | 04/17/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386837227 | NPI | - | NPPES |
BCP70271F | Medicaid | CA | |
FHC70271F | Medicaid | CA |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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