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NPI Code Detail

MEDICARE: FAMILY HEALTH CENTERS OF SAN DIEGO INC

MEDICARE: FAMILY HEALTH CENTERS OF SAN DIEGO INC
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)080000115CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1HAP11812GOTHERCAFAMILY P.A.C.T.

General Provider Information

NPI Number : 1851577662
Entity Type Code : Organization
Provider Name (Legal Business Name) : FAMILY HEALTH CENTERS OF SAN DIEGO INC
Provider Business Mailing Address
First Line : 823 GATEWAY CENTER WAY
Second Line :
City : SAN DIEGO
State : CA
Zip : 92102-4541
Country : US
Telephone Number : 619-515-2300
Fax Number : 619-515-0211
Provider Business Practice Location Address
First Line : 3705 MISSION BLVD
Second Line :
City : SAN DIEGO
State : CA
Zip : 92109-7104
Country : US
Telephone Number : 619-515-2300
Fax Number : 858-488-1394
Authorized Official
Title or Position : CFO
Name : RICARDO ROMAN
Credential :
Telephone Number : 619-515-2300
Provider Enumeration Date : 01/11/2008
Last Update Date : 06/08/2026

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1386689701 — FAMILY HEALTH CENTERS OF SAN DIEGO, INC
Practice Location Address:
3705 MISSION BLVD
SAN DIEGO, CA
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Practice Fax: 858-488-1394
1346337904 — DR. MARK E BRODSKY MD
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1285772392 — BEVERLY S LEONARD CPNP
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1306065032 — KELLSIE ANN MICHAEL ASW
Practice Location Address:
3705 MISSION BLVD
SAN DIEGO, CA
92109-7104
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Practice Fax:
1396956512 — MS. YANA GEPSHTEIN CNM
Practice Location Address:
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SAN DIEGO, CA
92109-7104
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Practice Fax:
1427242239 — TINA MARIE MITTERLING PA-C
Practice Location Address:
3705 MISSION BLVD
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92109-7104
Practice Phone: 619-515-2444
Practice Fax:

Directions to “FAMILY HEALTH CENTERS OF SAN DIEGO INC ” Practice Location

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