Organization
CELEBRATING LIFE COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SERGEY P SERGEYEV (CEO)
(949) 866-3600
Entity
Organization
Contact information
Practice address
700 W 19TH ST STE A&B, COSTA MESA, CA 92627-3517
(949) 866-3600
Mailing address
27800 MEDICAL CENTER RD STE 110, MISSION VIEJO, CA 92691-6407
(949) 433-6686
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
09/22/2022
Last updated
09/22/2022
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