Organization
FAMILY HEALTH CENTERS OF SAN DIEGO, INC
Active
Other names
North Park Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICARDO ROMAN (CFO)
(619) 906-4603
Entity
Organization
Contact information
Practice address
3544 30TH ST, SAN DIEGO, CA 92104-4120
(619) 515-2424
(619) 683-7570
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300
(619) 237-1856
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
090000469
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CGP162351
GHPP
CA
05
—
FHC70583F
—
CA
01
—
W5352A
MEDICARE PART B
CA
Enumeration date
06/18/2006
Last updated
02/19/2024
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