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General NPI Number Information
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NPI Number | 1023022092
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Entity Type | Organization
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Legal Business Name | EAST COUNTY FAMILY HEALTH CENTER INC
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Dates
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Enumeration Date | 07/28/2006
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Last Update Date | 03/22/2019
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Provider Practice Location Address
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Address Line | 330 S. MAGNOLIA AVE. SUITE 101
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City | EL CAJON
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State | CA
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Zip | 92020
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Country | US
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Telephone | 619-861-4123
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Fax | 858-676-0035
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Provider Business Mailing Address
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Address Line | 330 S. MAGNOLIA AVE. SUITE 101
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City | EL CAJON
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State | CA
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Zip | 92020
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Country | US
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Telephone | 619-861-4123
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Fax | 858-676-0035
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Authorized Official
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Title or Position | MD
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Name | MUMTAZ ALMANSOUR
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Credential | MD
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Telephone | 619-620-5632
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | A55926
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License Number State | CA
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