NPIMap

Organization Active NPI

Family Health Centers of San Diego

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
National Provider Identifier
1104002914
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
License
080000115 Issued in CA
Legal business name
FAMILY HEALTH CENTERS OF SAN DIEGO
Practice address
3705 Mission Blvd
San Diego, CA 92109-7104
Phone
(619) 515-2300
Fax
(858) 488-1394
NPI assigned
Jan 11, 2008
Organization subpart
Yes
Parent organization
FAMILY HEALTH CENTERS OF SAN DIEGOAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ricardo Roman
Title
Cfo
Phone
(619) 515-2300

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X 080000115 CA Primary

Addresses

Primary practice location

3705 Mission Blvd
San Diego, CA 92109-7104

Mailing address

823 Gateway Center Way
San Diego, CA 92102-4541
Phone (619) 515-2300

Other identifiers 1

IdentifierTypeStateIssuer
BCP11812GOtherCACDP

Other names 1

  • BEACH AREA FAMILY HEALTH CENTER Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Family Health Centers116 organizations share this tax ID, including this one
Part of
Family Health Centers

Organizations with this tax ID in the same state 22

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 22

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200009600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708387200000",
    "number": "1104002914",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 GATEWAY CENTER WAY",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921024541",
            "telephone_number": "619-515-2300",
            "fax_number": "619-515-0211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 MISSION BLVD",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921097104",
            "telephone_number": "619-515-2300",
            "fax_number": "858-488-1394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY HEALTH CENTERS OF SAN DIEGO",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "FAMILY HEALTH CENTERS OF SAN DIEGO",
        "enumeration_date": "2008-01-11",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A",
        "authorized_official_last_name": "ROMAN",
        "authorized_official_first_name": "RICARDO",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "619-515-2300"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": "CA",
            "license": "080000115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CDP",
            "identifier": "BCP11812G",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BEACH AREA FAMILY HEALTH CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in San Diego, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.