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Organization

MOUNTAIN HEALTH & COMMUNITY SERVICES, INC.

Active
Other names
Escondido Family Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
JUDITH SHAPLIN (CEO)
(619) 445-6200
Entity
Organization

Contact information

Practice address
255 N ASH ST STE 101, ESCONDIDO, CA 92027-3069
(760) 745-5832
(760) 745-7847
Mailing address
31115 HIGHWAY 94, CAMPO, CA 91906-3133
(619) 478-5254
(619) 478-9164

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
550000560
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BCP71188F
STATE PROGRAM
CA
05
FHC71188F
CA
01
HAP71188F
STATE PROGRAM
CA
Enumeration date
05/29/2007
Last updated
10/05/2011
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