Organization
AMPLA HEALTH
Active
Organization
AMPLA HEALTH
Active
Other names
AMPLA HEALTH LINDHURST MEDICAL & DENTAL
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BENJAMIN H FLORES MPH (PRESIDENT, CHIEF EXECUTIVE OFFICER)
(530) 751-3778
Entity
Organization
Contact information
Practice address
4941 OLIVEHURST AVE., OLIVEHURST, CA 95961-4225
(530) 743-4611
(530) 743-5770
Mailing address
PO BOX AD, YUBA CITY, CA 95992-1396
(530) 751-3778
(530) 751-1237
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
230000147
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP03867F
EWC:CDP:BCEDP
CA
05
—
FHC03867F
—
CA
01
—
HAP03867F
FAMILY PLANNING
CA
Enumeration date
07/08/2006
Last updated
02/29/2024
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