| Share Our Selves Corporation | |
|
1000 N Kraemer Pl Ste 204 Anaheim CA 92806-2610 | |
| (949) 270-2100 | |
| (949) 650-4458 |
| Full Name | Share Our Selves Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1000 N Kraemer Pl Ste 204, Anaheim, California |
| Authorized Official Name and Position | Christy Ward (CEO) |
| Authorized Official Contact | 9495363927 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Share Our Selves Corporation Po Box 10159 Costa Mesa CA 92627-0050 Ph: (949) 270-2100 | Share Our Selves Corporation 1000 N Kraemer Pl Ste 204 Anaheim CA 92806-2610 Ph: (949) 270-2100 |
| NPI Number | 1184279952 |
|---|---|
| Provider Enumeration Date | 08/07/2019 |
| Last Update Date | 07/29/2020 |
| Medicare PECOS PAC ID | 4789854993 |
|---|---|
| Medicare Enrollment ID | O20200728001441 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184279952 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
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