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Organization

FAMILY HEALTH CENTERS OF SAN DIEGO INC

Active
Other names
OAK PARK FAMILY HEALTH CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MR. RICARDO ROMAN (CFO)
(619) 515-2300
Entity
Organization

Contact information

Practice address
5160 FEDERAL BLVD, SAN DIEGO, CA 92105-5429
(619) 515-2454
(619) 794-2696
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
550000465
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
751838
NORIDIAN MEDICARE
CA
Enumeration date
08/06/2015
Last updated
02/20/2024
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