| Beach Area Family Health Center | |
|
3705 Mission Blvd San Diego CA 92109-7104 | |
| (619) 515-2444 | |
| (858) 488-1394 |
| Full Name | Beach Area Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3705 Mission Blvd, San Diego, California |
| Authorized Official Name and Position | Ricardo Roman (CFO) |
| Authorized Official Contact | 6195152300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Beach Area Family Health Center 823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | Beach Area Family Health Center 3705 Mission Blvd San Diego CA 92109-7104 Ph: (619) 515-2444 |
| NPI Number | 1386689701 |
|---|---|
| Provider Enumeration Date | 06/19/2006 |
| Last Update Date | 02/20/2024 |
| Medicare PECOS PAC ID | 3476446378 |
|---|---|
| Medicare Enrollment ID | O20100825000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386689701 | NPI | - | NPPES |
| FHC11812G | Medicaid | CA | |
| W5352 | Other | CA | MEDICARE - NHIC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 080000115 (California) | Primary |
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