Provider Demographics
NPI:1215484142
Name:APEX ANNEX HEALTH CENTER,INC
Entity type:Organization
Organization Name:APEX ANNEX HEALTH CENTER,INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:DIANE
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:209-826-2222
Mailing Address - Street 1:400 W I ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:LOS BANOS
Mailing Address - State:CA
Mailing Address - Zip Code:93635-3459
Mailing Address - Country:US
Mailing Address - Phone:209-827-9999
Mailing Address - Fax:
Practice Address - Street 1:400 WEST I STREET
Practice Address - Street 2:SUITE A
Practice Address - City:LOS BANOS
Practice Address - State:CA
Practice Address - Zip Code:93635
Practice Address - Country:US
Practice Address - Phone:209-827-9999
Practice Address - Fax:209-827-0011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA3938036OtherARTICLES OF INCORPORATION