Organization
LAKE COUNTY TRIBAL HEALTH CONSORTIUM INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ERNESTO PADILLA JR. (EXECUTIVE DIRECTOR)
(707) 263-8382
Entity
Organization
Contact information
Practice address
925 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8382
(707) 263-0329
Mailing address
925 BEVINS CT, LAKEPORT, CA 95453-9754
(707) 263-8382
(707) 263-0329
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
110000289
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
THP70611F
—
CA
Enumeration date
05/27/2005
Last updated
03/03/2026
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