Organization
FAMILY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICARDO ROMAN (CFO)
(619) 515-2300
Entity
Organization
Contact information
Practice address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2322
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
28620
CA
Other
Enumeration date
11/22/2006
Last updated
02/19/2024
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