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PQ OUTREACH COALITION NPI 1619279361


NPI Information

NPI: 1619279361
Provider Name: PQ OUTREACH COALITION

Other Name: IMPACT COMMUNITY CLINIC

Classification: Point of Service - 305S00000X
Entity Type: Organization
Address:
10060 CARMEL MOUNTAIN RD
SAN DIEGO, CA
ZIP 92129
Phone: (858) 206-1860
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PQ OUTREACH COALITION is a point of service in San Diego, CA. The provider is this product may also be called an open-ended HMO and offers a transition product incorporating features of both HMOs and PPOs. Beneficiaries are enrolled in an HMO but have the option to go outside the networks for an additional cost. PQ OUTREACH COALITION NPI is 1619279361. The provider is registered as an organization entity type.
The provider Other Name Is Impact Community Clinic.

The provider's business location address is:

10060 CARMEL MOUNTAIN RD
SAN DIEGO, CA
ZIP 92129-228
Phone: (858) 206-1860
Fax: (858) 484-8577

The provider's authorized official is William Kenneth Harmaning .
The authorized official title is CHAIR BOARD OF DIRECTORSBoard Of Directors and has the following contact phone number (858) 206-1860.

The enumeration date for this NPI number is 12/1/2010 and was last updated on 12/1/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1305S00000XPoint of ServiceYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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