Organization
COUNTY OF SAN JOAQUIN
Active
Organization
COUNTY OF SAN JOAQUIN
Active
Parent organization
COUNTY OF SAN JOAQUIN
Other names
San Joaquin County Clinics Mobile Location 1
Organization subpart
Yes
Provider details
NPI number
Legal business name
COUNTY OF SAN JOAQUIN
Authorized official
DR. FARHAN FADOO MD (CEO)
(209) 468-5623
Entity
Organization
Contact information
Practice address
500 W HOSPITAL RD STE A, FRENCH CAMP, CA 95231-9693
(209) 468-6937
(209) 468-6114
Mailing address
10100 TRINITY PKWY STE 100, STOCKTON, CA 95219-7239
(209) 468-5623
(209) 468-6114
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
030000087
NA
CA
Enumeration date
10/28/2021
Last updated
10/28/2021
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