Organization
VIA CARE COMMUNITY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VANESSA FUENTES (BILLING MANAGER)
(323) 268-9191
Entity
Organization
Contact information
Practice address
4476 TWEEDY BLVD STE B, SOUTH GATE, CA 90280-6359
(323) 268-9191
Mailing address
501 S ATLANTIC BLVD, LOS ANGELES, CA 90022-2621
(323) 268-9191
(323) 268-9119
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Enumeration date
12/16/2020
Last updated
03/02/2022
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