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157 E Valley Pkwy Ste 100 Escondido CA 92025-2762 | |
| (706) 546-2094 | |
| (760) 546-2095 |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 157 E Valley Pkwy Ste 100, Escondido, California |
| Authorized Official Name and Position | Ricardo Roman (CHIEF FINANCIAL OFFICER) |
| Authorized Official Contact | 6199064603 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
823 Gateway Center Way San Diego CA 92102-4541 Ph: (619) 515-2300 | 157 E Valley Pkwy Ste 100 Escondido CA 92025-2762 Ph: (706) 546-2094 |
| NPI Number | 1356178180 |
|---|---|
| Provider Enumeration Date | 09/16/2024 |
| Last Update Date | 09/18/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1356178180 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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