NORTH EAST MEDICAL SERVICES - STOCKTON – NPI #1518911304
Clinic/Center

NORTH EAST MEDICAL SERVICES - STOCKTON is an AHC clinic located in SAN FRANCISCO, CA. NPPES has assigned the NPI number 1518911304 to NORTH EAST MEDICAL SERVICES - STOCKTON on May 19, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “NORTH EAST MEDICAL SERVICES - STOCKTON” is a dba name, the actual legal business name for this organization is NORTH EAST MEDICAL SERVICES. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC)

The NPI profile was previously updated about 4 years ago on Mar 04, 2022. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTH EAST MEDICAL SERVICES - STOCKTON below.

NPI Profile for
NORTH EAST MEDICAL SERVICES

NPI Number
1518911304
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTH EAST MEDICAL SERVICES
Doing Business As (dba): NORTH EAST MEDICAL SERVICES - STOCKTON
Primary location
1520 STOCKTON STREET
SAN FRANCISCO, CA 94133-3354
Phone: (415) 391-9686 Fax: (415) 433-4726
Mailing address
2171 JUNIPERO SERRA BLVD STE 700
DALY CITY, CA 94014-1982
Phone: Fax: (415) 433-4726
Organization Subpart
Yes - NORTH EAST MEDICAL SERVICES - STOCKTON is subpart of another organization.
Authorized Official
EDDIE CHAN
PRESIDENT & CEO
Phone: (415) 391-9686
Updated
Certification Date
Mar 04, 2022

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NORTH EAST MEDICAL SERVICES - STOCKTON

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
MEDICAIDCAEAP11007F
MEDICAIDCAGR0028720
MEDICAIDCAFHC11007F
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QF0400X
- Clinic/Center / Federally Qualified Health Center (FQHC) (Primary)
CA 220000118
251X00000X
- Supports Brokerage
171M00000X
- Case Manager/Care Coordinator

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.