Mid-City Community Clinic
LBN: San Diego Family Care
Mid-City Community Clinic is an health care organization with primary practice located at 4290 Polk Ave , San Diego CA 92105-1524. The organization recently has only one registered license in Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), which is considered as the primary health care specialty.
San Diego Family Care can be contacted via phone (619) 563-0507, or through Feinberg, Roberta Lee via phone (619) 563-0507.
Contact Information
Primary practice address
4290 Polk Ave
San Diego CA 92105-1524
Phone: (619) 563-0507
Fax: (619) 563-0015
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | California |
Profile Details
| NPI number | 1306827332 |
|---|---|
| LBN Legal business name | San Diego Family Care |
| DBA Doing business as | Mid-City Community Clinic |
| Authorized official | Feinberg, Roberta Lee MS |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | Nov 8th, 2005 |
| Last updated | Jul 23rd, 2007 - about 17 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1306827332 | NPPES |
| California | Other | HAP 11882 G | SOFP |
| California | Other | FHC 11882 G | SOFP |
| California | Other | 80406 | SOFP |
| California | Other | W815 | SOFP |
| California | Other | EAP 11672 F | SOFP |
| California | Other | BCP 11882 F | SOFP |
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