COMMUNITY MEDICAL CENTERS, INC (NPI# 1285059923) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285059923 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL CENTERS, INC |
| Other Organization Name | COMMUNITY MEDICAL CENTERS, WATERLOO |
| Practice Address |
1031 Waterloo Rd Stockton CA 95205-4256 |
| Mailing Address |
7210 Murray Dr Stockton CA 95210-3339 |
| Practice Telephone | 2099405600 |
| Practice Fax Number | 2099405065 |
| Mailing Telephone | 2093732800 |
| Mailing Fax Number | 2093732879 |
| Enumeration Date | 2014-03-04 |
| Last Update Date | 2015-06-16 |
| Authorized Official Name | MR. ART FEAGLES (CFO) |
| Authorized Official Telephone | 2093732803 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Community Medical Centers, Waterloo | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 1699766519 | Community Medical Centers, Inc | Clinic/Center | 131 W A St Ste 1, Dixon Family Practice, Dixon, CA 95620-3437 | 2005-10-31 |
| 1609867787 | Community Medical Centers, Inc | Clinic/Center | 730 N Central Ave, Tracy, CA 95376-4104 | 2005-10-28 |
| 1578552543 | Community Medical Centers, Inc | Clinic/Center | 701 E Channel St, Stockton, CA 95202-2628 | 2005-10-20 |
| 1932633930 | Community Medical Centers, Inc | Clinic/Center | 83 W March Ln, Stockton, CA 95207-5730 | 2017-04-17 |
| 1710211214 | Community Medical Centers, Inc | Clinic/Center | 200 Cottage Ave Ste 103, Manteca, CA 95336-4935 | 2009-09-30 |
| 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 |
1031 WATERLOO RD |
| City | STOCKTON |
| State | CA |
| Zip Code | 95205-4256 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609183748 | Crystal Thao | Social Worker | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2010-09-10 |
| 1629609284 | La Roy'a Rochell Peace | Social Worker | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2020-01-31 |
| 1184192411 | Adriana Vanessa Nunez Lopez | Nurse Practitioner | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2018-11-05 |
| 1245672716 | Hailu Solomon Mehanzel | Dentist | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2013-07-24 |
| 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 |
| 1164586772 | Community Medical Centers, Inc. | Clinic/Center | 2640 E Lafayette St, Stockton, CA 95205-5713 | 2006-12-20 |
| 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 |
| 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.