Organization
VALLEY CHILDREN'S HOSPITAL
Active
Other names
Charlie Mitchell Rural Health Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TINA MYCROFT (SENIOR VP & CFO)
(559) 353-3000
Entity
Organization
Contact information
Practice address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8762
(559) 353-3000
Mailing address
9300 VALLEY CHILDRENS PL, MADERA, CA 93636-8762
(559) 353-3000
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
040000160
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
RHM1860F
—
CA
01
—
ZZZ64542Z
BLUE SHIELD RHC PID
CA
Enumeration date
12/13/2006
Last updated
01/14/2025
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