Organization
SOUTH BAY FAMILY HEALTHCARE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANN HAMILITON-LEE (PRESIDENT-CEO)
(310) 802-6177
Entity
Organization
Contact information
Practice address
2114 ARTESIA BLVD, REDONDO BEACH, CA 90278-3014
(310) 802-6177
(310) 802-6178
Mailing address
23430 HAWTHORNE BLVD, BLDG 3, SUITE 210, TORRANCE, CA 90505-4720
(310) 802-6177
(310) 802-6178
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EAP70236F
EAPC
CA
05
—
FHC70843F
—
CA
01
—
HAP70843F
FAMPACT
CA
Enumeration date
02/08/2007
Last updated
10/05/2007
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