| Lemon Grove Family Health Center | |
|
7592 Broadway Lemon Grove CA 91945-1604 | |
| (619) 515-2300 | |
| (619) 237-1856 |
| Full Name | Lemon Grove Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 7592 Broadway, Lemon Grove, 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 |
|---|---|
| Lemon Grove Family Health Center 823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | Lemon Grove Family Health Center 7592 Broadway Lemon Grove CA 91945-1604 Ph: (619) 515-2300 |
| NPI Number | 1427282466 |
|---|---|
| Provider Enumeration Date | 05/05/2009 |
| Last Update Date | 02/20/2024 |
| Medicare PECOS PAC ID | 3476446378 |
|---|---|
| Medicare Enrollment ID | O20100623000616 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427282466 | NPI | - | NPPES |
| 050000300 | Other | CA | LICENSE - STATE OF CALIFORNIA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 050000300 (California) | Primary |
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