COMMUNITY MEDICAL CENTERS, INC (NPI# 1578552543) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578552543 |
| Entity Type | Organization |
| Organization Name | COMMUNITY MEDICAL CENTERS, INC |
| Other Organization Name | CHANNEL MEDICAL CENTER |
| Practice Address |
701 E Channel St Stockton CA 95202-2628 |
| Mailing Address |
Po Box 779 Stockton CA 95201-0779 |
| Practice Telephone | 2099444700 |
| Practice Fax Number | 2099446715 |
| Mailing Telephone | 2093732800 |
| Mailing Fax Number | 2093732878 |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2010-07-14 |
| Authorized Official Name | MR. 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) |
030000561 | CA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CA | FHC70629F | 05 |
| Other Name | Type Code |
|---|---|
| channel medical center | 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 |
| 1932633930 | Community Medical Centers, Inc | Clinic/Center | 83 W March Ln, Stockton, CA 95207-5730 | 2017-04-17 |
| 1285059923 | Community Medical Centers, Inc | Clinic/Center | 1031 Waterloo Rd, Stockton, CA 95205-4256 | 2014-03-04 |
| 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 |
701 E CHANNEL ST |
| City | STOCKTON |
| State | CA |
| Zip Code | 95202-2628 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376175265 | Lisa Gildea | Dental Hygienist | 701 E Channel St, Stockton, CA 95202-2628 | 2020-02-07 |
| 1427524156 | Katherine Francis Ketz | Nurse Practitioner | 701 E Channel St, Stockton, CA 95202-2628 | 2018-10-20 |
| 1639676422 | Olivia Millan | Lactation Consultant, Non-RN | 701 E Channel St, Stockton, CA 95202-2628 | 2018-04-09 |
| 1982101911 | Erin Kathleen Garcia | Dietitian, Registered | 701 E Channel St, Stockton, CA 95202-2628 | 2018-04-06 |
| 1871092320 | Pam Thao | Assistant Behavior Analyst | 701 E Channel St, Stockton, CA 95202-2628 | 2018-02-09 |
| 1336665587 | Elaine Sze Ho | Family Medicine | 701 E Channel St, Stockton, CA 95202-2628 | 2017-08-18 |
| 1770036642 | Pak-hei Hui | Pharmacist | 701 E Channel St, Stockton, CA 95202-2628 | 2016-07-27 |
| 1417361395 | Issa Sidibe | Nurse Practitioner | 701 E Channel St, Stockton, CA 95202-2628 | 2014-06-18 |
| 1821381179 | David Graham | Nurse Practitioner | 701 E Channel St, Stockton, CA 95202-2628 | 2011-05-19 |
| 1649588393 | Elizabeth Ann Simmons | Registered Nurse | 701 E Channel St, Stockton, CA 95202-2628 | 2010-09-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336774678 | Lecletus Griffin Jr. | Counselor | 1212 N. Califronia Street, Stockton, CA 95202 | 2020-03-06 |
| 1861035586 | Andrea Mn Perkins | Social Worker | Sjc Bhs Bacop, 1149 El Dorado Street, Stockton, CA 95202 | 2019-10-25 |
| 1932664620 | San Joaquin County Behavioral Health Services | Community/Behavioral Health | 1212 N. Califorian St, Stockton, CA 95202 | 2019-02-06 |
| 1730655895 | Jenaiah La'neise Sauceda | Social Worker | 343 E Main St Ste 918, Stockton, CA 95202 | 2018-10-16 |
| 1235631722 | Parker Yang | Counselor | 1111 N. El Dorado St, Stockton, CA 95202 | 2018-03-01 |
| 1912406976 | Janet Mendoza | Social Worker | 6 South Eldorado Street, Stockton, CA 95202 | 2018-02-06 |
| 1487162087 | Linda Soun | Counselor | 1111 N. El Dorado Street, Stockton, CA 95202 | 2018-01-17 |
| 1124545355 | Suleyma Velesquez | Counselor | 445 N. San Joaquin St., Stockton, CA 95202 | 2017-08-28 |
| 1821513946 | Savoeun Phal | Counselor | 1212 N California St Ste A214, Stockton, CA 95202 | 2017-08-09 |
| 1861921272 | Mandeep K Minhas | Registered Nurse | 1212 California St, Stockton, CA 95202 | 2017-06-08 |
| Find all providers in zip 95202 | ||||
| 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 |
| 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.