Organization
VENICE FAMILY CLINIC
Active
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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