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Organization
LIFELONG MEDICAL CARE
Active
Organization
LIFELONG MEDICAL CARE
Active
Parent organization
LIFELONG MEDICAL CARE
Other names
LifeLong William Jenkins Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LIFELONG MEDICAL CARE
Authorized official
DAVID B. VLIET (CEO)
(510) 981-4123
Entity
Organization
Contact information
Practice address
150 HARBOUR WAY, RICHMOND, CA 94801-3554
(510) 237-9537
(510) 981-4191
Mailing address
PO BOX 11247, BERKELEY, CA 94712-2247
(510) 981-4100
(510) 981-4193
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
550000122
CA
261QD0000X
Dental Clinic/Center
—
NULL
Other
Enumeration date
03/26/2007
Last updated
01/19/2021
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