Organization
FAMILY HEALTH CENTERS OF SAN DIEGO INC
Active
Other names
Diamond Neighborhoods Family Health Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RICARDO ROMAN (CFO)
(619) 906-4603
Entity
Organization
Contact information
Practice address
4725 MARKET ST, SAN DIEGO, CA 92102-4715
(619) 515-2326
(619) 683-7570
Mailing address
823 GATEWAY CENTER WAY, SAN DIEGO, CA 92102-4541
(619) 515-2300
(619) 237-1856
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
051101
MEDICARE NGS
CA
01
—
BCP71172F
CDP
CA
01
—
BE886Y
MEDICARE PALMETTO GBA
CA
05
—
FHC71172F
—
CA
01
—
HAP71172F
FAMILY P.A.C.T.
CA
Enumeration date
02/14/2007
Last updated
02/19/2024
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