Venice Family Clinic | |
11802 York Ave Hawthorne CA 90250-3125 | |
(310) 392-8636 | |
Not Available |
Full Name | Venice Family Clinic |
---|---|
Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 11802 York Ave, Hawthorne, California |
Authorized Official Name and Position | Mitesh G Popat (CHIEF EXECUTIVE OFFICER) |
Authorized Official Contact | 3106647901 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Venice Family Clinic 604 Rose Ave Venice CA 90291-2767 Ph: (310) 392-8636 | Venice Family Clinic 11802 York Ave Hawthorne CA 90250-3125 Ph: (310) 392-8636 |
NPI Number | 1518739515 |
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Provider Enumeration Date | 10/24/2023 |
Last Update Date | 10/24/2023 |
Identifier | Type | State | Issuer |
---|---|---|---|
1518739515 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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