| Neighborhood Healthcare - Lakeside | |
|
10039 Vine St Lakeside CA 92040-3130 | |
| (619) 390-9975 | |
| (619) 390-9872 |
| Full Name | Neighborhood Healthcare - Lakeside |
|---|---|
| Speciality | Clinic/Center |
| Location | 10039 Vine St, Lakeside, California |
| Authorized Official Name and Position | Rakesh Patel (CEO) |
| Authorized Official Contact | 7605208300 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Neighborhood Healthcare - Lakeside 425 N Date St Escondido CA 92025-3413 Ph: (760) 737-2035 | Neighborhood Healthcare - Lakeside 10039 Vine St Lakeside CA 92040-3130 Ph: (619) 390-9975 |
| NPI Number | 1932384120 |
|---|---|
| Provider Enumeration Date | 01/07/2008 |
| Last Update Date | 04/16/2020 |
| Medicare PECOS PAC ID | 5294649406 |
|---|---|
| Medicare Enrollment ID | O20110211000888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932384120 | NPI | - | NPPES |
| FHC70605G | Medicaid | CA | |
| BCP70605G | Medicaid | CA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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