IMPERIAL BEACH COMMUNITY CLINIC NPI 1215246996

NPI Information

IMPERIAL BEACH COMMUNITY CLINIC is a community health clinic center in San Diego, CA. IMPERIAL BEACH COMMUNITY CLINIC NPI is 1215246996. The provider is registered as an organization entity type.
The provider Is Doing Business As Nestor Community Health Center.

The provider's business location address is:

1016 OUTER RD
SAN DIEGO, CA
ZIP 92154-351
Phone: (619) 429-3733
Fax: (619) 429-6457

The provider's authorized official is Constance Kirk .
The authorized official title is Executive Director and has the following contact phone number (619) 429-5387.

The CLIA number assigned to this NPI record is 05D2023199 - community clinic with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 9/29/2010 and was last updated on 9/29/2010.

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:

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