Organization
VENICE FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH FORER MSW MPH (CHIEF EXECUTIVE OFFICER)
(310) 664-7901
Entity
Organization
Contact information
Practice address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8630
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
960000169
CA
Other
Enumeration date
06/06/2008
Last updated
02/26/2010
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