Organization
CELEBRATING LIFE COMMUNITY HEALTH CENTER
Active
Organization
CELEBRATING LIFE COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SERGEY P SERGEYEV MPA (CEO)
(949) 433-6686
Entity
Organization
Contact information
Practice address
15785 LAGUNA CANYON RD STE 250, IRVINE, CA 92618-3179
(949) 866-3600
Mailing address
27800 MEDICAL CENTER RD STE 110, MISSION VIEJO, CA 92691-6407
(949) 433-6686
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1386273100
—
CA
Enumeration date
02/15/2023
Last updated
02/15/2023
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