Davis Community Clinic

LBN: Ole Health
Davis Community Clinic is an health care organization with primary practice located at 2051 John Jones Rd , Davis CA 95616-9701. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty. Ole Health can be contacted via phone (530) 758-2060, or through Macisaac, Rose via phone (760) 767-6435.

Contact Information

Primary practice address
2051 John Jones Rd Davis CA 95616-9701
Fax: (530) 758-8490
Website:
Authorized official contact:
Name: Macisaac, Rose

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) 261QF0400X 03000146 California

Profile Details

NPI number 1558366823
LBN Legal business name Ole Health
DBA Doing business as Davis Community Clinic
Authorized official Macisaac, Rose
Entity Organization
Organization subpart 1 No
Enumeration date Jun 14th, 2005
Last updated Oct 17th, 2023 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1558366823 NPPES
California MEDICAID FHC11771F

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