Organization
GOLDEN VALLEY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TONY WEBER (CEO)
(209) 384-6493
Entity
Organization
Contact information
Practice address
2760 3RD ST, CERES, CA 95307-3220
(209) 556-5011
(209) 556-5095
Mailing address
737 WEST CHILDS AVENUE, MERCED, CA 95340
(209) 384-6493
(209) 383-1296
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
050000303
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051089
MEDICARE NGS
CA
05
—
CMM71154F
—
CA
01
—
ZZZ50880Z
BLUE SHIELD OF CA
CA
Enumeration date
09/07/2006
Last updated
02/09/2017
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