| Mobile Counseling Center I | |
|
823 Gateway Center Way San Diego CA 92102-4541 | |
| (619) 515-2300 | |
| (619) 237-1856 |
| Full Name | Mobile Counseling Center I |
|---|---|
| Speciality | Clinic/Center |
| Location | 823 Gateway Center Way, San Diego, California |
| Authorized Official Name and Position | Ricardo Roman (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6199064603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mobile Counseling Center I 823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | Mobile Counseling Center I 823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 |
| NPI Number | 1700440781 |
|---|---|
| Provider Enumeration Date | 04/25/2019 |
| Last Update Date | 02/19/2024 |
| Medicare PECOS PAC ID | 3476446378 |
|---|---|
| Medicare Enrollment ID | O20220505001893 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700440781 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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