Organization
LA CLINICA DE LA RAZA INC
Active
Other names
Family Optical I
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA AGUILERA (CHIEF EXECUTIVE OFFICER)
(510) 535-2915
Entity
Organization
Contact information
Practice address
3060B E 9TH ST, OAKLAND, CA 94601-2322
(510) 535-5500
(510) 535-4349
Mailing address
PO BOX 22210, OAKLAND, CA 94623-2210
(510) 535-4000
(510) 535-4189
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
140000708
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC71063F
—
CA
Enumeration date
08/02/2006
Last updated
12/10/2014
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