Organization
SAN DIEGO FAMILY CARE
Active
Other names
Mid-City Community Clinic-Pediatrics
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ROBERTA LEE FEINBERG MS (CHIEF EXECUTIVE OFFICER)
(619) 563-0507
Entity
Organization
Contact information
Practice address
4305 UNIVERISTY AVE, SUITE 150, SAN DIEGO, CA 92105-1690
(619) 563-0507
(619) 563-0015
Mailing address
4305 UNIVERISTY AVE, SUITE 150, SAN DIEGO, CA 92105-1690
(619) 563-0507
(619) 563-0015
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
80406
HEALTHY FAMILIES
CA
01
—
EAP11672F
EXPANDED ACESS TO PRIMARY
CA
01
—
FHC71000G
MEDI CAL FQHC
CA
Enumeration date
11/07/2005
Last updated
08/22/2020
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