Organization
SHARE OUR SELVES CORPORATION
Active
Organization
SHARE OUR SELVES CORPORATION
Active
Other names
Share Our Selves Community Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTY WARD (CEO)
(949) 536-3927
Entity
Organization
Contact information
Practice address
1550 SUPERIOR AVE, COSTA MESA, CA 92627-3653
(949) 270-2100
(949) 515-5804
Mailing address
PO BOX 10159, COSTA MESA, CA 92627-0050
(949) 270-2100
(949) 515-5804
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CMM70513F
MEDI-CAL
CA
Enumeration date
05/17/2007
Last updated
10/02/2020
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