# IMPERIAL BEACH COMMUNITY CLINIC

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** IMPERIAL BEACH COMMUNITY CLINIC
- **Other names:** Nestor Community Health Center
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1215246996
- **Legal business name:** IMPERIAL BEACH COMMUNITY CLINIC
- **Authorized official:** CONSTANCE KIRK (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (619) 429-5387

## Contact information

- **Practice address:** 1016 OUTER RD, SAN DIEGO, CA 92154-1351
- **Practice address phone:** (619) 429-3733
- **Practice address fax:** (619) 429-6457
- **Mailing address:** PO BOX 459, IMPERIAL BEACH, CA 91933-0459
- **Mailing address phone:** (619) 429-3733
- **Mailing address fax:** (619) 429-6457

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/29/2010
- **Last updated:** 09/29/2010