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CH09123S LA CLINICA DE LA RAZA, INC. (Active)
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Main Details
Name
LA CLINICA DE LA RAZA, INC.
Subdivision Name
La Clinica Dental at Children's Hospital Oakland
Type
HRSA-Funded Health Center
Site ID
BPS-H80-024681
340B ID
CH09123S
Grant Number
H80CS00631
Additional Details
Current Program Status
Active
Registration Date
1/10/2013
Participating Start Date
4/1/2013
Participating Approval Date
2/26/2013
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
4881 Telegraph Ave
Oakland, CA 94609-2009
Billing Address
La Clinica de La Raza, Inc
P.O. Box 22210
Oakland, CA 94623
Comments
Medicaid Billing
Shipping Addresses
Contract Pharmacies
Grantee Sites
Grantee Sites Contract Pharmacies
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April 2025
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