SAN DIEGO FAMILY CARE NPI 1306827332

NPI Information

NPI: 1306827332
Provider Name: SAN DIEGO FAMILY CARE

Doing Business As: MID-CITY COMMUNITY CLINIC

Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
4290 POLK AVE
SAN DIEGO, CA
ZIP 92105
Phone: (619) 563-0507
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SAN DIEGO FAMILY CARE is a federally qualified health center (fqhc) clinic center in San Diego, CA. SAN DIEGO FAMILY CARE NPI is 1306827332. The provider is registered as an organization entity type.
The provider Is Doing Business As Mid-city Community Clinic.

The provider's business location address is:

4290 POLK AVE
SAN DIEGO, CA
ZIP 92105-524
Phone: (619) 563-0507
Fax: (619) 563-0015

The provider's authorized official is Roberta Lee Feinberg .
The authorized official title is Chief Executive Officer and has the following contact phone number (619) 563-0507.

The enumeration date for this NPI number is 11/8/2005 and was last updated on 7/23/2007.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)		CALIFORNIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	W815	OTHER	CALIFORNIA	OTHER
2	BCP 11882 F	OTHER	CALIFORNIA	BCP
3	80406	OTHER	CALIFORNIA	HEALTHY FAMILIES
4	EAP 11672 F	OTHER	CALIFORNIA	EXPANDED ACCESS TO PRIMAR
5	051875 (UGS)	MEDICARE ID-TYPE UNSPECIFIED	CALIFORNIA
6	HAP 11882 G	OTHER	CALIFORNIA	SOFP
7	FHC 11882 G	OTHER	CALIFORNIA	MEDI-CAL (FQHC)

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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