Organization
COMMUNITY MEDICAL CENTERS, INC.
Active
Organization
COMMUNITY MEDICAL CENTERS, INC.
Active
Other names
Lawrence Family Center & Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL H. KIRKPATRICK (CHIEF EXECUTIVE OFFICER)
(209) 373-2833
Entity
Organization
Contact information
Practice address
721 CALAVERAS STREET, LODI, CA 95240-0628
(209) 331-8019
(209) 331-8018
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
0300000424
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70460F
—
CA
Enumeration date
12/20/2006
Last updated
12/03/2008
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