Organization
VENICE FAMILY CLINIC
Active
Other names
Venice Family Clinic Access Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CARMEN IBARRA (CHIEF OPERATING OFFICER)
(310) 664-7667
Entity
Organization
Contact information
Practice address
503 OLYMPIC BLVD, SANTA MONICA, CA 90401-3311
(310) 392-8636
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
960000960
CA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
03/05/2012
Last updated
09/29/2021
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