Organization
COMMUNITY MEDICAL CENTERS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL H. KIRKPATRICK (CHIEF EXECUTIVE OFFICER)
(209) 373-2833
Entity
Organization
Contact information
Practice address
1721 E HAMMER LN, SUITE A, STOCKTON, CA 95210-4116
(209) 751-5200
(209) 751-5252
Mailing address
PO BOX 779, STOCKTON, CA 95201-0779
(209) 373-2833
(209) 373-2878
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
—
1538223375
—
CA
Enumeration date
12/19/2006
Last updated
05/05/2010
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