Organization
VENICE FAMILY CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIZABETH BENSON FORER (CEO)
(310) 664-7901
Entity
Organization
Contact information
Practice address
2509 PICO BLVD, SANTA MONICA, CA 90405-1828
(310) 664-7878
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
HY13130
CA
Other
Enumeration date
08/19/2015
Last updated
09/09/2015
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