Organization
COMMUNITY MEDICAL CENTERS, INC.
Active
Organization
COMMUNITY MEDICAL CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MICHELLE RENEE BAGALAYOS (DIRECTOR OF FINANCE)
(209) 373-2838
Entity
Organization
Contact information
Practice address
200 COTTAGE AVE STE 103, MANTECA, CA 95336-4935
(209) 624-5800
(209) 624-5801
Mailing address
7210 MURRAY DR, STOCKTON, CA 95210-3339
(209) 373-2800
(209) 373-2879
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550000238
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1710211214
—
CA
Enumeration date
12/30/2011
Last updated
12/30/2011
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