Organization
FAMILY HEALTH CENTERS OF SAN DIEGO, INC.
Active
Parent organization
FAMILY HEALTH CENTERS OF SAN DIEGO INC
Other names
CCS/GHPP Dental
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY HEALTH CENTERS OF SAN DIEGO INC
Authorized official
RICARDO ROMAN (CFO)
(619) 515-2300
Entity
Organization
Contact information
Practice address
1809 NATIONAL AVE, SAN DIEGO, CA 92113-2113
(619) 515-2300
(619) 234-2447
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300
(619) 237-1856
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
090000113
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CGP169666
—
CA
Enumeration date
08/20/2007
Last updated
02/20/2024
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