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CH09123P LA CLINICA DE LA RAZA, INC. (Active)
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Main Details
Name
LA CLINICA DE LA RAZA, INC.
Subdivision Name
LA CLINICA MONUMENT
Type
HRSA-Funded Health Center
Site ID
BPS-H80-010550
340B ID
CH09123P
Grant Number
H80CS00631
Additional Details
Current Program Status
Active
Registration Date
10/1/2003
Participating Start Date
10/1/2003
Participating Approval Date
10/10/2003
Last Recertification Date
2/11/2025
Contacts
Authorizing Official
La Clinica de La Raza
Jane Garcia, CEO
(510) 535-4000
Primary Contact
La Clinica de La Raza
Dolly Davar, Pharmacy Director
(510) 535-3382
Addresses
Street Address
2000 Sierra Rd
Concord, CA 94518
Billing Address
LA CLINICA DE LA RAZA
P.O. BOX 22210
OAKLAND, CA 94623
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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2/28/12 - Changed main address from 2100 MONUMENT BOULEVARD SUITE 8. 6/8/10 UPDATED BILL TO (WAS 1515 FRUITVALE AVE, 94601)
02/28/2012
6/8/10 UPDATED BILL TO (WAS 1515 FRUITVALE AVE, 94601)
06/08/2010
April 2025
April 2025
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