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Organization

SAN DIEGO FAMILY CARE

Active
Other names
Mid City Community Clinic
Organization subpart
No

Provider details

NPI number
Authorized official
MS. ROBERTA LEE FEINBERG MS (CHIEF EXECUTIVE OFFICER)
(858) 279-9676
Entity
Organization

Contact information

Practice address
4290 POLK AVENUE, SAN DIEGO, CA 92105-1524
(619) 563-0507
(619) 563-0015
Mailing address
6973 LINDA VISTA ROAD, SAN DIEGO, CA 92111-6339
(858) 279-9676
(858) 279-0377

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
HAP11882G
HAP
CA
Enumeration date
02/26/2007
Last updated
08/22/2020
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