Provider Demographics
NPI:1821593971
Name:UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Entity Type:Organization
Organization Name:UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGED CARE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NAVJOT
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:559-646-6618
Mailing Address - Street 1:PO BOX 790
Mailing Address - Street 2:
Mailing Address - City:PARLIER
Mailing Address - State:CA
Mailing Address - Zip Code:93648-0790
Mailing Address - Country:US
Mailing Address - Phone:559-646-3561
Mailing Address - Fax:559-646-4963
Practice Address - Street 1:250 E HANFORD ARMONA RD
Practice Address - Street 2:
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93245-2141
Practice Address - Country:US
Practice Address - Phone:559-997-6140
Practice Address - Fax:559-924-6006
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-29
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherTAX ID