Organization
COMMUNITY MEDICAL CENTERS
Active
Other names
san andreas clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL B WANDEL (CFO)
(209) 944-4710
Entity
Organization
Contact information
Practice address
265 W SAINT CHARLES ST, # 3, SAN ANDREAS, CA 95249-9618
(209) 755-1400
(209) 755-1430
Mailing address
PO BOX 779, STOCKTON, CA 95201-0779
(209) 944-4710
(209) 944-4796
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC70461F
—
CA
Enumeration date
10/31/2005
Last updated
08/22/2020
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