Organization
FAMILY HEALTH CENTERS OF SAN DIEGO, INC
Active
Other names
Beach Area Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO ROMAN (CFO)
(619) 515-2300
Entity
Organization
Contact information
Practice address
3705 MISSION BLVD, SAN DIEGO, CA 92109-7104
(619) 515-2444
(858) 488-1394
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
080000115
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
FHC11812G
—
CA
01
—
W5352
MEDICARE - NHIC
CA
Enumeration date
06/19/2006
Last updated
02/20/2024
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