| NPI | 1215358924 |
|---|---|
| Doing Business As | DAVIS STREET PRIMARY CARE CLINIC |
| Entity Type | Organization |
| Authorized Contact | ROSALIA AQUINO MCMILLEN Chief Fiscal Officer 510-347-4620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QD0000X Clinic/Center, Dental | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2020-04-01 |