| St. Vincent De Paul Village, Inc. | |
|
16 15th Street San Diego CA 92101-7638 | |
| (619) 446-2100 | |
| Not Available |
| Full Name | St. Vincent De Paul Village, Inc. |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 16 15th Street, San Diego, California |
| Authorized Official Name and Position | Jimmy Vargas (PRESIDENT AND CEO) |
| Authorized Official Contact | 6194462100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| St. Vincent De Paul Village, Inc. 3350 E St San Diego CA 92102-3332 Ph: (619) 446-2100 | St. Vincent De Paul Village, Inc. 16 15th Street San Diego CA 92101-7638 Ph: (619) 446-2100 |
| NPI Number | 1649655812 |
|---|---|
| Provider Enumeration Date | 07/29/2015 |
| Last Update Date | 07/29/2015 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649655812 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | 370110AN (California) | Primary |
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