Provider Demographics
NPI:1134668429
Name:CHEST CLINIC
Entity Type:Organization
Organization Name:CHEST CLINIC
Other - Org Name:SACRAMENTO COUNTY PUBLIC HEALTH CLINIC
Other - Org Type:Other Name
Authorized Official - Title/Position:MEDICAL DIRECTOR- CHEST CLINIC
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BERTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:916-874-9823
Mailing Address - Street 1:4600 BROADWAY
Mailing Address - Street 2:SUITE # 1300
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95820-1527
Mailing Address - Country:US
Mailing Address - Phone:916-874-9823
Mailing Address - Fax:916-854-9614
Practice Address - Street 1:4600 BROADWAY
Practice Address - Street 2:SUITE # 1300
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95820-1527
Practice Address - Country:US
Practice Address - Phone:916-874-9823
Practice Address - Fax:916-854-9614
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA172V00000X261QP0905X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP0905XAmbulatory Health Care FacilitiesClinic/CenterPublic Health, State or Local