| 25th Street Family Medicine | |
|
316 25th St San Diego CA 92102-3016 | |
| (619) 238-5551 | |
| (619) 238-3807 |
| Full Name | 25th Street Family Medicine |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 316 25th St, San Diego, California |
| Authorized Official Name and Position | Judith Shaplin (CEO) |
| Authorized Official Contact | 6194456200 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| 25th Street Family Medicine 31115 Highway 94 Campo CA 91906-3133 Ph: (619) 478-5254 | 25th Street Family Medicine 316 25th St San Diego CA 92102-3016 Ph: (619) 238-5551 |
| NPI Number | 1861603151 |
|---|---|
| Provider Enumeration Date | 05/25/2007 |
| Last Update Date | 05/08/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861603151 | NPI | - | NPPES |
| BCP71185F | Other | CA | STATE PROGRAM |
| FHC71185F | Medicaid | CA | |
| HAP71185F | Other | CA | STATE PROGRAM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 550000543 (California) | Primary |
Revivify Restorative Medicine Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 16445 Bernardo Center Dr, San Diego, CA 92128 Phone: 858-429-0099 Fax: 858-676-1172 | |
Nucleus Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4570 Executive Dr Ste 100, San Diego, CA 92121 Phone: 844-838-3322 | |
Moden Medical Group Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 8901 Activity Rd Ste 205, San Diego, CA 92126 Phone: 888-822-1184 Fax: 888-877-3676 | |
Aldiwani Medical Group Corporation Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 11409 Windy Summit Pl, San Diego, CA 92127 Phone: 832-371-3279 Fax: 619-939-4556 | |
Presidio Medical Group Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4440 Lamont St, San Diego, CA 92109 Phone: 858-270-7633 Fax: 858-270-7692 | |
Michael L Butera Md Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 6699 Alvarado Rd Ste 2309, San Diego, CA 92120 Phone: 619-286-8803 Fax: 619-286-2344 | |
San Diego Digestive Disease Consultants, Inc. A Medical Group Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 8008 Frost St, Ste 200, San Diego, CA 92123 Phone: 858-292-7527 Fax: 858-292-7804 |