Organization
ST. VINCENT DE PAUL VILLAGE, INC
Active
Other names
St. Vincent de Paul Village Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MELINDA MALLIE (CHIEF FINANCIAL OFFICER)
(619) 446-2194
Entity
Organization
Contact information
Practice address
1501 IMPERIAL AVE, SAN DIEGO, CA 92101-7638
(619) 233-8500
(619) 645-6470
Mailing address
3350 E ST, SAN DIEGO, CA 92102-3332
(619) 233-8500
(619) 645-6470
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QH0100X
Health Service Clinic/Center
09000297
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CMM70389F
—
CA
Enumeration date
02/16/2007
Last updated
02/22/2023
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