Organization
UNITED HEALTH CENTERS OF THE SAN JOAQUIN VALLEY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN H FLORES (CEO)
(559) 646-6618
Entity
Organization
Contact information
Practice address
121 BARBOZA ST, MENDOTA, CA 93640-1901
(559) 655-5000
(559) 655-6818
Mailing address
PO BOX 790, PARLIER, CA 93648-0790
(559) 646-3561
(559) 646-3642
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ZZZ38220Z
BLUE SHIELD OF CA
CA
Enumeration date
05/22/2007
Last updated
08/22/2020
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