Organization
VENICE FAMILY CLINIC
Active
Parent organization
VENICE FAMILY CLINIC
Other names
Venice Family Clinic - Mobile Clinic # 3
Organization subpart
Yes
Provider details
NPI number
Legal business name
VENICE FAMILY CLINIC
Authorized official
DR. MITESH G POPAT MD (CHIEF EXECUTIVE OFFICER)
(310) 664-7901
Entity
Organization
Contact information
Practice address
622 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8636
Mailing address
604 ROSE AVE, VENICE, CA 90291-2767
(310) 392-8636
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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