Healthcare Provider Details

I. General information

NPI: 1699549311
Provider Name (Legal Business Name): COMMUNITY ACCESS CLINIC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/13/2023
Last Update Date: 06/18/2025
Certification Date: 06/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

502 EUCLID AVE STE 302
NATIONAL CITY CA
91950-2995
US

IV. Provider business mailing address

502 EUCLID AVE STE 302
NATIONAL CITY CA
91950-2995
US

V. Phone/Fax

Practice location:
  • Phone: 619-310-3633
  • Fax:
Mailing address:
  • Phone: 619-310-3633
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JEREMIE MICHAEL MEYERS
Title or Position: ADMINISTRATOR
Credential:
Phone: 619-310-3633