MEDICARE: NEIGHBORHOOD HEALTHCARE

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
1	261QF0400X	Federally Qualified Health Center (FQHC)

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1932384120
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NEIGHBORHOOD HEALTHCARE

Provider Business Mailing Address
First Line	:	425 N DATE ST
Second Line	:
City	:	ESCONDIDO
State	:	CA
Zip	:	92025-3413
Country	:	US
Telephone Number	:	760-737-2035
Fax Number	:	760-520-8318

Provider Business Practice Location Address
First Line	:	10039 VINE ST
Second Line	:
City	:	LAKESIDE
State	:	CA
Zip	:	92040-3130
Country	:	US
Telephone Number	:	619-390-9975
Fax Number	:	619-390-9872

Authorized Official
Title or Position	:	CEO
Name	:	RAKESH PATEL
Credential	:	MD,MBA,FAAFP,CPE
Telephone Number	:	760-520-8300

Provider Enumeration Date	:	01/07/2008
Last Update Date	:	04/16/2020

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Directions to “NEIGHBORHOOD HEALTHCARE ” Practice Location

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