Organization
GOLDEN VALLEY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GENEVIEVE MEDINA (CREDENTIALING MANAGER)
(209) 384-6493
Entity
Organization
Contact information
Practice address
3940 SANDPIPER AVE, MERCED, CA 95340-8372
(309) 383-1848
(209) 381-4109
Mailing address
737 W CHILDS AVE, MERCED, CA 95341-6805
(209) 383-1848
(855) 202-9336
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
040000513
CA
207R00000X
Internal Medicine Physician
040000513
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
363AM0700X
Medical Physician Assistant
040000513
CA
363LF0000X
Family Nurse Practitioner
040000513
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAP70909F
FPACT
CA
Enumeration date
04/26/2007
Last updated
01/08/2021
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