Organization
LAKE COUNTY TRIBAL HEALTH CONSORTIUM INC.
Active
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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