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Organization

COMMUNITY HEALTH CENTERS OF AMERICA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAMIE DOLE (MANAGER)
(209) 575-4575
Entity
Organization

Contact information

Practice address
5320 HIGHWAY 49 N, MARIPOSA, CA 95338-9588
(209) 575-4575
(209) 575-4598
Mailing address
PO BOX 3091, MODESTO, CA 95353-3091
(209) 575-4575
(209) 575-4575

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A86330
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
75-1169
CA
Enumeration date
11/02/2017
Last updated
01/21/2026
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