Provider Demographics
NPI:1871090472
Name:QUADMED MEDICAL CLINICS OF CALIFORNIA, INC.
Entity type:Organization
Organization Name:QUADMED MEDICAL CLINICS OF CALIFORNIA, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN
Authorized Official - Middle Name:B
Authorized Official - Last Name:MERKOW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:414-566-8400
Mailing Address - Street 1:N61 W23044 HARRY'S WAY
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:WI
Mailing Address - Zip Code:53089-3995
Mailing Address - Country:US
Mailing Address - Phone:414-566-8400
Mailing Address - Fax:414-566-8400
Practice Address - Street 1:2065 KEYSTONE PACIFIC PARKWAY
Practice Address - Street 2:
Practice Address - City:PATTERSON
Practice Address - State:CA
Practice Address - Zip Code:95363
Practice Address - Country:US
Practice Address - Phone:888-235-8462
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-10
Last Update Date:2020-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Single Specialty