Organization
BAY AREA COMMUNITY HEALTH
Active
Parent organization
BAY AREA COMMUNITY HEALTH
Other names
Bay Area Community Health - Independence High School Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
BAY AREA COMMUNITY HEALTH
Authorized official
JAGAT SHETH (CHIEF FINANCIAL OFFICER)
(510) 252-6810
Entity
Organization
Contact information
Practice address
617 N JACKSON AVE BLDG 1, SAN JOSE, CA 95133-2345
(408) 928-9599
Mailing address
40910 FREMONT BLVD, FREMONT, CA 94538-4375
(510) 770-8040
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1063658029
—
CA
Enumeration date
05/12/2020
Last updated
05/07/2021
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