Healthcare Provider Details

I. General information

NPI: 1023748571
Provider Name (Legal Business Name): FRIENDS OF FAMILY HEALTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2022
Last Update Date: 06/15/2022
Certification Date: 06/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14350 WHITTIER BLVD STE 103
WHITTIER CA
90605-2141
US

IV. Provider business mailing address

501 S IDAHO ST STE 100
LA HABRA CA
90631-6047
US

V. Phone/Fax

Practice location:
  • Phone: 562-693-8541
  • Fax: 562-690-3182
Mailing address:
  • Phone: 562-690-0400
  • Fax: 562-690-3182

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: NICOLIS ARIAS
Title or Position: CREDENTIALING
Credential:
Phone: 562-690-0400