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General NPI Number Information
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NPI Number | 1043926009
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Entity Type | Organization
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Legal Business Name | OPERATION SAMAHAN INC
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Dates
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Enumeration Date | 01/24/2023
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Last Update Date | 01/24/2023
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Provider Practice Location Address
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Address Line | 480 4TH AVE STE 401
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City | CHULA VISTA
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State | CA
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Zip | 91910-4413
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Country | US
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Telephone | 844-200-2426
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Fax | 619-356-2726
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Provider Business Mailing Address
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Address Line | 1428 HIGHLAND AVE
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City | NATIONAL CITY
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State | CA
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Zip | 91950-4624
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Country | US
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Telephone | 844-200-2426
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Fax | 619-356-2726
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | ARCHIE PALIS BELLA
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Credential | MD
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Telephone | 760-969-7770
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QF0400X
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Taxonomy Name | Federally Qualified Health Center (FQHC)
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License Number |
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License Number State |
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