VENICE FAMILY CLINIC NPI 1205100468

NPI Information

VENICE FAMILY CLINIC is a federally qualified health center (fqhc) clinic center in Santa Monica, CA. VENICE FAMILY CLINIC NPI is 1205100468. The provider is registered as an organization entity type.
The provider Other Name Is Venice Family Clinic Access Center.

The provider's business location address is:

503 OLYMPIC BLVD
SANTA MONICA, CA
ZIP 90401-311
Phone: (310) 392-8636

The provider's authorized official is Carmen Ibarra .
The authorized official title is Chief Operating Officer and has the following contact phone number (310) 664-7667.

The CLIA number assigned to this NPI record is 05D0917672 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 3/5/2012 and was last updated on 9/29/2021.

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:

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