Lake County Tribal Health Consortium Inc.
NPI #1881697381 in Lakeport, California
Provider Information
- NPI Number
- 1881697381
- Entity Type
- Organization
- Organization Name
- Lake County Tribal Health Consortium Inc.
- Primary Specialty
- Clinic/Center - Federally Qualified Health Center (FQHC)
- Enumeration Date
- May 27, 2005
- Last Updated
- Nov 16, 2011
Practice Location
- Address
- 925 BEVINS CT
- City
- Lakeport
- State
- California
- ZIP Code
- 95453-9754
- Phone
- (707) 263-8382
Authorized Official
- Name
- MR. ERNESTO PADILLA JR.
- Title
- EXECUTIVE DIRECTOR
- Phone
- (707) 263-8382
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Federally Qualified Health Center (FQHC) — Federally Qualified Health Center (FQHC) |
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