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Organization

MENDOCINO COMMUNITY HEALTH CLINIC, INC.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. ANTONIA DELGADO VEGA (BILLING MANAGER)
(707) 467-2260
Entity
Organization

Contact information

Practice address
333 LAWS AVE, UKIAH, CA 95482-6540
(707) 468-1010
(707) 468-0174
Mailing address
333 LAWS AVE, UKIAH, CA 95482-6540
(707) 468-1010
(707) 468-0174

Taxonomy

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

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
EAP03933F
EAPC
CA
05
FHC03933F
CA
01
HAP03933F
FAMILY PACT
CA
Enumeration date
03/29/2006
Last updated
05/07/2019
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