| Celebrating Life Community Health Center | |
|
1444 S Main St Santa Ana CA 92707-1717 | |
| (949) 866-3600 | |
| Not Available |
| Full Name | Celebrating Life Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 1444 S Main St, Santa Ana, California |
| Authorized Official Name and Position | Sergey P Sergeyev (CEO) |
| Authorized Official Contact | 9498663600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Celebrating Life Community Health Center 27800 Medical Center Rd Ste 110 Mission Viejo CA 92691-6407 Ph: (949) 866-3600 | Celebrating Life Community Health Center 1444 S Main St Santa Ana CA 92707-1717 Ph: (949) 866-3600 |
| NPI Number | 1013630128 |
|---|---|
| Provider Enumeration Date | 09/22/2022 |
| Last Update Date | 09/22/2022 |
| Medicare PECOS PAC ID | 4789015140 |
|---|---|
| Medicare Enrollment ID | O20230404002195 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013630128 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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