Healthcare Provider Details

I. General information

NPI: 1356892509
Provider Name (Legal Business Name): SANTA FE COMMUNITY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/21/2016
Last Update Date: 10/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12631 IMPERIAL HWY STE 100
SANTA FE SPRINGS CA
90670-4710
US

IV. Provider business mailing address

12631 IMPERIAL HWY STE 100
SANTA FE SPRINGS CA
90670-4710
US

V. Phone/Fax

Practice location:
  • Phone: 562-864-4002
  • Fax:
Mailing address:
  • Phone: 562-864-4002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA50311
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA50311
License Number StateCA

VIII. Authorized Official

Name: DR. HEIDI ANN WINKLER
Title or Position: PRESIDENT/MEDICAL DIRECTOR
Credential: MD
Phone: 562-864-4002