NPIMap

Organization Active NPI

Community Medical Centers

  • Federally Qualified Health Center (FQHC)
  • Stockton, CA
National Provider Identifier
1396918835
Registry record updated Apr 4, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY MEDICAL CENTERS
Practice address
2003 E Mariposa Rd
Stockton, CA 95205-7735
Phone
(209) 751-1900
Fax
(209) 751-1950
NPI assigned
Apr 4, 2008
Last updated
Apr 4, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Paul B Wandel
Title
Cfo
Phone
(209) 373-2828

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

2003 E Mariposa Rd
Stockton, CA 95205-7735

Mailing address

PO Box 779
Stockton, CA 95201-0779
Phone (209) 373-2828

Other identifiers 1

IdentifierTypeStateIssuer
BCP99999OtherCABCCCP

National Provider Directory

National Provider Directory
Tax ID family
Woodridge Medical GRP65 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1207267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1207267200000",
    "number": "1396918835",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 779",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952010779",
            "telephone_number": "209-373-2828",
            "fax_number": "209-373-2878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 E MARIPOSA RD",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952057735",
            "telephone_number": "209-751-1900",
            "fax_number": "209-751-1950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY MEDICAL CENTERS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-04",
        "last_updated": "2008-04-04",
        "status": "A",
        "authorized_official_last_name": "WANDEL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "209-373-2828",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCCCP",
            "identifier": "BCP99999",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockton, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.