COMMUNITY MEDICAL CENTERS, INC. (NPI# 1407978620) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407978620 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL CENTERS, INC. |
| Other Organization Name | TRACY FAMILY PRACTICE |
| Practice Address |
730 Central Ave Tracy CA 95376-4104 |
| Mailing Address |
Po Box 779 Stockton CA 95201-0779 |
| Practice Telephone | 2098201500 |
| Practice Fax Number | 2098201525 |
| Mailing Telephone | 2098201500 |
| Mailing Fax Number | 2098201525 |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MICHAEL H. KIRKPATRICK (CEO) |
| 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) |
CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | BCCCP | BCP70462F | 01 |
| Other Name | Type Code |
|---|---|
| Tracy Family Practice | 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 |
| 1164586772 | Community Medical Centers, Inc. | Clinic/Center | 2640 E Lafayette St, Stockton, CA 95205-5713 | 2006-12-20 |
| 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 |
| 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 |
730 CENTRAL AVE |
| City | TRACY |
| State | CA |
| Zip Code | 95376-4104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831278365 | Reshma Anil Wadhwani | Pediatrics | 730 Central Ave, Tracy, CA 95376-4104 | 2006-11-03 |
| 1144532581 | Alecia Rae Jeppson | Social Worker | 730 Central Ave, Tracy, CA 95376-4104 | 2010-07-13 |
| 1669594545 | Community Medical Centers, Inc. | Clinic/Center | 730 Central Ave, Tracy, CA 95376-4104 | 2007-04-04 |
| 1225156375 | Community Medical Centers | Clinic/Center | 730 Central Ave, Tracy, CA 95376-4104 | 2007-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932757150 | James Burgess Angel | Technician, Other | 455 W. Eaton Ave., Tracy, CA 95376 | 2019-08-30 |
| 1477079655 | Cassandra Sierra | Specialist/Technologist | 632 W 11th St Ste 119, Tracy, CA 95376 | 2017-08-18 |
| 1922465491 | Jasmeer Kaur Uppal | Registered Nurse | 1411 N. Tracy Bl., Tracy, CA 95376 | 2016-01-28 |
| 1679957773 | Amy Forester | Physical Therapy Assistant | 1752 Schantz Way, Tracy, CA 95376 | 2015-07-17 |
| 1477966265 | Sarah Ojeda | Marriage & Family Therapist | 19 East 6th Street, Tracy, CA 95376 | 2014-06-09 |
| 1356761209 | Lucille Nowakowski | Registered Nurse | 95 West 11 Th St, Tracy, CA 95376 | 2014-04-18 |
| 1821417718 | Ricardo Echon | Nurse Practitioner | 644 W 12th Street, Tracy, CA 95376 | 2014-04-08 |
| 1508105354 | Sutter Central Valley Hospitals | Pharmacy | 1420 N. Tracy Blvd., Tracy, CA 95376 | 2013-02-13 |
| 1790034056 | Amy Powers | Counselor | 902 N Central Ave Ste 308, Tracy, CA 95376 | 2012-09-02 |
| 1982951554 | Gurpreet Singh Dhaliwal Md Inc. | Anesthesiology | 1530 Bessie Ave Ste 104, Tracy, CA 95376 | 2012-08-13 |
| Find all providers in zip 95376 | ||||
| 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 |
|---|---|---|---|---|
| 1609867787 | Community Medical Centers, Inc | Clinic/Center | 730 N Central Ave, Tracy, CA 95376-4104 | 2005-10-28 |
| 1164919049 | Community Medical Centers Inc | Clinic/Center | 2151 W Grant Line Rd, Tracy, CA 95377-7309 | 2018-04-17 |
| 1497261606 | Community Medical Centers Inc | Clinic/Center | 2135 N Tracy Blvd, Tracy, CA 95376-2424 | 2017-12-26 |
| 1669594545 | Community Medical Centers, Inc. | Clinic/Center | 730 Central Ave, Tracy, CA 95376-4104 | 2007-04-04 |
| 1225156375 | Community Medical Centers | Clinic/Center | 730 Central Ave, Tracy, CA 95376-4104 | 2007-03-27 |
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| 1083221451 | Harmony Health Medical Clinic and Family Resource Center | Clinic/Center | 1930 N. Beale Road, Marysville, CA 95901-6915 | 2020-09-29 |
| 1235745928 | Community Medical Centers Inc | Clinic/Center | 747 E Channel St, Stockton, CA 95202-2628 | 2020-09-18 |
| 1760098503 | Chicago Clinica Medica Familiar Operated By Neighborhood Healthcare | Clinic/Center | 4022 Chicago Ave Ste A, Riverside, CA 92507-5340 | 2020-09-17 |
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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.