Organization
COMMUNITY MEDICAL CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL B WANDEL (CFO)
(209) 373-2828
Entity
Organization
Contact information
Practice address
600 NUT TREE RD STE 310, VACAVILLE, CA 95687-4686
(707) 359-1800
(707) 359-1837
Mailing address
PO BOX 779, STOCKTON, CA 95201-0779
(209) 373-2828
(209) 373-2878
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
BCP99999
BCCCP
CA
Enumeration date
04/04/2008
Last updated
04/04/2008
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