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Organization

STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES

Active
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Organization

STATE OF CALIFORNIA - DEPARTMENT OF DEVELOPMENTAL SERVICES

Active
Other names
Lanterman Community Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MARK HUTCHINSON (DEPUTY DIRECTOR)
(916) 654-1897
Entity
Organization

Contact information

Practice address
3530 W POMONA BLVD, POMONA, CA 91768-3238
(909) 444-7000
Mailing address
1600 9TH ST STE 205, MS 2-3, SACRAMENTO, CA 95814-6435
(916) 654-2431
(916) 653-4587

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
CA

Other

Enumeration date
12/30/2011
Last updated
01/17/2012
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