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NPI Code Detail

MEDICARE: SAN DIEGO FAMILY CARE

MEDICARE: SAN DIEGO FAMILY CARE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1261QF0400XFederally Qualified Health Center (FQHC)

General Provider Information

NPI Number : 1386168193
Entity Type Code : Organization
Provider Name (Legal Business Name) : SAN DIEGO FAMILY CARE
Provider Business Mailing Address
First Line : 6973 LINDA VISTA RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-6342
Country : US
Telephone Number : 858-279-9676
Fax Number : 858-279-0377
Provider Business Practice Location Address
First Line : 6979 LINDA VISTA RD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92111-6342
Country : US
Telephone Number : 858-279-0925
Fax Number : 858-633-4680
Authorized Official
Title or Position : CEO
Name : ROBERTA LEE FEINBERG
Credential : M.S.
Telephone Number : 858-279-9676
Provider Enumeration Date : 08/02/2017
Last Update Date : 08/02/2017

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Directions to “SAN DIEGO FAMILY CARE ” Practice Location

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