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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