Organization
BAY AREA COMMUNITY HEALTH
Active
Parent organization
BAY AREA COMMUNITY HEALTH
Other names
Bay Area Community Health- Mowry I Clinic, Mowry I
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAY AREA COMMUNITY HEALTH
Authorized official
DR. ZETTIE D PAGE III MD, PH.D, MBA, MSW, (CEO)
(510) 252-6811
Entity
Organization
Contact information
Practice address
2299 MOWRY AVE STE 3B, FREMONT, CA 94538-1621
(510) 770-8040
(510) 623-8926
Mailing address
40910 FREMONT BLVD, FREMONT, CA 94538-4375
(510) 770-8040
(510) 623-8926
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
140000481
CLINIC LICENSE
CA
05
—
FHC70603F
—
CA
Enumeration date
11/01/2006
Last updated
04/01/2022
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