Provider Demographics
NPI:1841622180
Name:NATIVE AMERICAN HEALTH CENTER INC
Entity type:Organization
Organization Name:NATIVE AMERICAN HEALTH CENTER INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR REGISTRATION AND BILLING
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:ANTOINE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-485-5942
Mailing Address - Street 1:3124 INTERNATIONAL BLVD
Mailing Address - Street 2:ROOM 314
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94601-2902
Mailing Address - Country:US
Mailing Address - Phone:510-434-5379
Mailing Address - Fax:510-261-1841
Practice Address - Street 1:160 CAPP ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-1210
Practice Address - Country:US
Practice Address - Phone:415-417-3597
Practice Address - Fax:415-503-1081
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATIVE AMERICAN HEALTH CENTER INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-08-08
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAGR#2061SM#059036OtherURBAN TRAILS SAN FRANCISCO