| North Park Family Health Center | |
|
3544 30th St San Diego CA 92104-4120 | |
| (619) 515-2424 | |
| (619) 683-7570 |
| Full Name | North Park Family Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 3544 30th St, San Diego, California |
| Authorized Official Name and Position | Ricardo Roman (CFO) |
| Authorized Official Contact | 6199064603 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Park Family Health Center 823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | North Park Family Health Center 3544 30th St San Diego CA 92104-4120 Ph: (619) 515-2424 |
| NPI Number | 1700821303 |
|---|---|
| Provider Enumeration Date | 06/18/2006 |
| Last Update Date | 02/19/2024 |
| Medicare PECOS PAC ID | 3476446378 |
|---|---|
| Medicare Enrollment ID | O20100825000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1700821303 | NPI | - | NPPES |
| CGP162351 | Other | CA | GHPP |
| FHC70583F | Medicaid | CA | |
| W5352A | Other | CA | MEDICARE PART B |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | 090000469 (California) | Primary |
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