Healthcare Provider Details

I. General information

NPI: 1447847207
Provider Name (Legal Business Name): NEIGHBORHOOD HEALTHCARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2020
Last Update Date: 05/30/2024
Certification Date: 05/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4371 LATHAM ST
RIVERSIDE CA
92501-1706
US

IV. Provider business mailing address

215 S HICKORY ST
ESCONDIDO CA
92025-4359
US

V. Phone/Fax

Practice location:
  • Phone: 833-867-4642
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: RAKESH R PATEL
Title or Position: CEO
Credential: MD, CEO
Phone: 760-520-8300