Organization
LA CLINICA DE LA RAZA TRANSIENT VILLAGE
Active
Parent organization
LA CLINICA DE LA RAZA
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA DE LA RAZA
Authorized official
DR. ARIANE TERLET DDS (CHIEF DENTAL DIRECTOR)
(510) 535-4713
Entity
Organization
Contact information
Practice address
3451 E 12TH ST, OAKLAND, CA 94601-3463
(510) 535-4000
Mailing address
3451 E 12TH ST, OAKLAND, CA 94601-3463
(510) 535-4000
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
25801
CA
Other
Enumeration date
07/15/2011
Last updated
07/15/2011
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