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Organization

GOLDEN VALLEY HEALTH CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. TONY WEBER CEO (CEO)
(209) 385-5551
Entity
Organization

Contact information

Practice address
1540 FLORIDA AVENUE, MODESTO, CA 95350-4437
(209) 574-1030
(209) 574-1038
Mailing address
737 W CHILDS AVE, MERCED, CA 95341-6805
(209) 385-5529
(209) 383-1296

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
662674
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
662674
CLINIC LICENSE NUMBER
CA
Enumeration date
11/13/2014
Last updated
11/13/2014
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  • EDI platform