Organization
FAMILY HEALTH CENTERS OF SAN DIEGO INC
Active
Other names
CHULA VISTA FAMILY COUNSELING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICARDO ROMAN (CFO)
(619) 515-2300
Entity
Organization
Contact information
Practice address
248 LANDIS AVE, CHULA VISTA, CA 91910-2609
(619) 515-2562
(619) 269-0115
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300
(619) 237-1856
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
751865
NORIDIAN MEDICARE
CA
Enumeration date
04/15/2016
Last updated
02/20/2024
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