Organization
FAMILY HEALTH CENTERS OF SAN DIEGO
Active
Parent organization
FAMILY HEALTH CENTERS OF SAN DIEGO
Other names
CHASE AVENUE FAMILY HEALTH CENTER
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY HEALTH CENTERS OF SAN DIEGO
Authorized official
RICARDO ROMAN (CFO)
(619) 515-2300
Entity
Organization
Contact information
Practice address
1111 W CHASE AVE, EL CAJON, CA 92020-5710
(619) 515-2300
(619) 593-9164
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300
(619) 515-0211
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
090000631
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
HAP70856F
FAMILY PACT
CA
Enumeration date
01/11/2008
Last updated
02/19/2024
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