Organization
BAY AREA COMMUNITY HEALTH
Active
Organization
BAY AREA COMMUNITY HEALTH
Active
Parent organization
BAY AREA COMMUNITY HEALTH
Other names
Bay Area Community Health - Main Street Village
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAY AREA COMMUNITY HEALTH
Authorized official
DR. ZETTIE D PAGE III MD, PHD, MBA, MSW, M (CEO)
(510) 252-6811
Entity
Organization
Contact information
Practice address
3607 MAIN ST STE B, FREMONT, CA 94538-4390
(510) 770-8040
(510) 623-8926
Mailing address
40910 FREMONT BLVD, FREMONT, CA 94538-4375
(510) 770-8040
(510) 623-8926
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550002016
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1497021109
—
CA
01
—
550002016
CLINIC LICENSE
CA
Enumeration date
03/27/2012
Last updated
05/07/2021
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