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905 Venice Blvd Venice CA 90291-4904 | |
(310) 392-8630 | |
Not Available |
Full Name | |
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Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
Location | 905 Venice Blvd, Venice, 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 |
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604 Rose Ave Venice CA 90291-2767 Ph: (310) 392-8636 | 905 Venice Blvd Venice CA 90291-4904 Ph: (310) 392-8630 |
NPI Number | 1275792020 |
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Provider Enumeration Date | 06/06/2008 |
Last Update Date | 09/11/2023 |
Identifier | Type | State | Issuer |
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1275792020 | NPI | - | NPPES |
Venice Family Clinic Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 622 Rose Ave, Venice, CA 90291 Phone: 310-392-8636 | |