COMMUNITY MEDICAL CENTERS, INC. (NPI# 1164586772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164586772 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL CENTERS, INC. |
| Other Organization Name | KING FAMILY CENTER HEALTH CLINIC |
| Practice Address |
2640 E Lafayette St Stockton CA 95205-5713 |
| Mailing Address |
P. O. Box 779 7210 Murray Dr Stockton CA 95201-0779 |
| Practice Telephone | 2099337232 |
| Practice Fax Number | 2094666527 |
| Mailing Telephone | 2093732833 |
| Mailing Fax Number | 2093732878 |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. MICHAEL H. KIRKPATRICK (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 2093732833 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
0300000561 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC70629F | 05 |
| Other Name | Type Code |
|---|---|
| King Family Center Health Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669720157 | Community Medical Centers, Inc. | Clinic/Center | 2015 S Mariposa Rd, Stockton, CA 95205-7735 | 2012-08-15 |
| 1588729180 | Community Medical Centers, Inc. | Clinic/Center | 17050 S. Grafton Street, Esparto, CA 95627 | 2006-12-26 |
| 1659435279 | Community Medical Centers, Inc. | Clinic/Center | 721 Calaveras Street, Lodi, CA 95240-0628 | 2006-12-20 |
| 1457621922 | Community Medical Centers, Inc. | Clinic/Center | 200 Cottage Ave Ste 103, Manteca, CA 95336-4935 | 2011-12-30 |
| 1285912956 | Community Medical Centers, Inc. | Clinic/Center | 200 Cottage Ave Ste 103, Manteca, CA 95336-4935 | 2011-07-29 |
| 1144413709 | Community Medical Centers, Inc. | Clinic/Center | 701 E Channel St, Stockton, CA 95202-2628 | 2007-08-27 |
| 1881887446 | Community Medical Centers, Inc. | Clinic/Center | 701 E Channel St, Stockton, CA 95202-2628 | 2007-08-27 |
| 1174646335 | Community Medical Centers, Inc. | Clinic/Center | 131 W A St, Dixon, CA 95620-3437 | 2007-04-10 |
| 1407978620 | Community Medical Centers, Inc. | Clinic/Center | 730 Central Ave, Tracy, CA 95376-4104 | 2007-04-06 |
| 1801918743 | Community Medical Centers, Inc. | Clinic/Center | 2401 W Turner Rd, Suite 450, Lodi, CA 95242-2182 | 2007-04-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | COMMUNITY MEDICAL CENTERS, INC. | 7210 Murray Dr, Stockton, CA 95210-3339 |
| Street Address |
2640 E LAFAYETTE ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95205-5713 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841801081 | Telegenx, LLC | Durable Medical Equipment & Medical Supplies | 127 S Locust St, Stockton, CA 95205 | 2020-08-12 |
| 1487130191 | Rassiwala Dental Corporation | Dentist | 2043 E Fremont St Ste 8, Stockton, CA 95205 | 2018-07-16 |
| 1518464692 | Szarisse Fernandez | Pharmacist | 2040 E. Mariposa Rd., Stockton, CA 95205 | 2018-04-06 |
| 1467820019 | San Joaquin County Bhs | Non-emergency Medical Transport (VAN) | 1149 N. El Dorado St., Stockton, CA 95205 | 2015-09-11 |
| 1346617651 | Kevin G.y. Tom | Pharmacist | 1528 Fremont St, Stockton, CA 95205 | 2015-08-24 |
| 1578749149 | Peebles Family Care Home | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 404 North Broadway Ave, Stockton, CA 95205 | 2008-01-14 |
| 1780874149 | Mv Transportation | Non-emergency Medical Transport (VAN) | 1250 South Wilson Way, Mv Transportation Ste #a1, Stockton, CA 95205 | 2007-07-31 |
| 1467513549 | Stockton Pharmacy | Pharmacy | 3330 E Main St, Stockton, CA 95205 | 2006-12-13 |
| 1174155170 | Phillip Brandon Long | Pharmacist | 2040 E Mariposa Rd, Stockton, CA 95205 | 2020-02-07 |
| 1558904136 | Angela Moss Burns | Counselor | 430 N Pilgrim St, Stockton, CA 95205 | 2019-10-25 |
| Find all providers in zip 95205 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235745928 | Community Medical Centers Inc | Clinic/Center | 747 E Channel St, Stockton, CA 95202-2628 | 2020-09-18 |
| 1891328803 | Community Medical Centers Inc | Clinic/Center | 1800 S Sutter St # 11b, Stockton, CA 95206-2004 | 2020-02-18 |
| 1558726786 | Community Medical Centers, Inc | Clinic/Center | 2044 Fair St, Stockton, CA 95206-2313 | 2015-12-14 |
| 1649525544 | Community Medical Centers, Inc | Clinic/Center | 423 S San Joaquin St, Community Medical Centers Gleason, Stockton, CA 95203-3537 | 2012-07-17 |
| 1306984315 | Community Medical Centers, Inc | Clinic/Center | 2003 E Mariposa Rd, Stockton, CA 95205-7735 | 2007-02-02 |
| 1578552543 | Community Medical Centers, Inc | Clinic/Center | 701 E Channel St, Stockton, CA 95202-2628 | 2005-10-20 |
| 1407460751 | Community Medical Centers Inc | Clinic/Center | 5151 Pacific Ave, Lock Center Room 126 & 128, Stockton, CA 95207-6304 | 2020-09-03 |
| 1205395712 | Community Medical Centers Inc | Clinic/Center | 1425 S Center St, Stockton, CA 95206-2016 | 2019-03-14 |
| 1205306628 | Community Medical Centers Inc | Clinic/Center | 2349 N California St, Stockton, CA 95204-5505 | 2018-11-28 |
| 1700373008 | Community Medical Centers Inc | Clinic/Center | 7912 West Ln Ste 221, Stockton, CA 95210-3159 | 2018-04-23 |
| Find all providers in STOCKTON | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.