| Celebrating Life Community Health Center | |
|
15785 Laguna Canyon Rd Ste 250 Irvine CA 92618-3179 | |
| (949) 866-3600 | |
| Not Available |
| Full Name | Celebrating Life Community Health Center |
|---|---|
| Speciality | Clinic/Center |
| Location | 15785 Laguna Canyon Rd Ste 250, Irvine, California |
| Authorized Official Name and Position | Sergey P Sergeyev (CEO) |
| Authorized Official Contact | 9494336686 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Celebrating Life Community Health Center 27800 Medical Center Rd Ste 110 Mission Viejo CA 92691-6407 Ph: (949) 433-6686 | Celebrating Life Community Health Center 15785 Laguna Canyon Rd Ste 250 Irvine CA 92618-3179 Ph: (949) 866-3600 |
| NPI Number | 1558068098 |
|---|---|
| Provider Enumeration Date | 02/15/2023 |
| Last Update Date | 02/15/2023 |
| Medicare PECOS PAC ID | 4789015140 |
|---|---|
| Medicare Enrollment ID | O20230522001676 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558068098 | NPI | - | NPPES |
| 1386273100 | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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