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Organization

BAY AREA COMMUNITY HEALTH

Active
Parent organization
BAY AREA COMMUNITY HEALTH
Organization subpart
Yes

Provider details

NPI number
Legal business name
BAY AREA COMMUNITY HEALTH
Authorized official
MR. ZETTIE D PAGE III M.D., PH.D, MBA, MSW (CEO)
(510) 252-6811
Entity
Organization

Contact information

Practice address
3607 MAIN ST, SUITE 3B, 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
01
550002016
CLINIC LICENSE
CA
Enumeration date
05/13/2015
Last updated
07/16/2020
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