<unavail> in Venice, CA - Medicare Clinic/Center

is a medicare enrolled primary clinic (Clinic/center - Federally Qualified Health Center (fqhc)) in Venice, California. The current practice location for is 905 Venice Blvd, Venice, California. For appointments, you can reach them via phone at (310) 392-8638. The mailing address for is 604 Rose Ave, Venice, California and phone number is (310) 392-8636.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1124054564. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (310) 392-8638.

Contact Information


	905 Venice Blvd Venice CA 90291-4904
	(310) 392-8638
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Clinic/Center
Location	905 Venice Blvd, Venice, California
Authorized Official Name and Position	Mitesh G Popat (CHIEF EXECUTIVE OFFICER)
Authorized Official Contact	3106647901
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
604 Rose Ave Venice CA 90291-2767 Ph: (310) 392-8636	905 Venice Blvd Venice CA 90291-4904 Ph: (310) 392-8638

NPI Details:

NPI Number	1124054564
Provider Enumeration Date	06/25/2006
Last Update Date	09/07/2023

Medicare PECOS Information:

Medicare PECOS PAC ID	2264339126
Medicare Enrollment ID	O20150813009805

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1124054564	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
261QC1500X	Clinic/center - Community Health	960000959 (California)	Secondary
261QF0400X	Clinic/center - Federally Qualified Health Center (fqhc)	(* (Not Available))	Primary

Reviews and Comments

Clinic/Center in Venice, CA

Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 2469 Lincoln Blvd, Venice, CA 90291 Phone: 310-392-8636
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Sunset Ave, Venice, CA 90291 Phone: 310-392-8630
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 717 Lincoln Blvd, Venice, CA 90291 Phone: 310-399-9883 Fax: 310-399-9678
Venice Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 622 Rose Ave, Venice, CA 90291 Phone: 310-392-8636
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 604 Rose Ave, Venice, CA 90291 Phone: 310-392-8630
Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 320 Lincoln Blvd, #100, Venice, CA 90291 Phone: 310-807-1373

- Medicare Primary Care in Venice, CA