NPIMap

Organization Active NPI

San Diego Family Care

Doing business as Mid-City Community Clinic-Pediatrics

  • Federally Qualified Health Center (FQHC)
  • San Diego, CA
National Provider Identifier
1962483040
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SAN DIEGO FAMILY CARE
Doing business as
Mid-City Community Clinic-Pediatrics
Practice address
4305 Univeristy Ave
Suite 150
San Diego, CA 92105-1690
Phone
(619) 563-0507
Fax
(619) 563-0015
NPI assigned
Nov 7, 2005
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Roberta Lee Feinberg, MS
Title
Chief Executive Officer
Phone
(619) 563-0507

Specialties & licenses 1

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

Addresses

Primary practice location

4305 Univeristy Ave
Suite 150
San Diego, CA 92105-1690

Mailing address

4305 Univeristy Ave
Suite 150
San Diego, CA 92105-1690
Phone (619) 563-0507

Other names 1

  • Mid-City Community Clinic-Pediatrics Doing business as

National Provider Directory

National Provider Directory

Locations

6973 Linda Vista Rd
San Diego, CA 92111
Phone (858) 279-0925

Practitioners & affiliated clinicians

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1131321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1962483040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4305 UNIVERISTY AVE",
            "address_2": "SUITE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051690",
            "telephone_number": "619-563-0507",
            "fax_number": "619-563-0015"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4305 UNIVERISTY AVE",
            "address_2": "SUITE 150",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921051690",
            "telephone_number": "619-563-0507",
            "fax_number": "619-563-0015"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN DIEGO FAMILY CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-07",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FEINBERG",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "619-563-0507",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mid-City Community Clinic-Pediatrics",
            "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 Aug 22, 2020; 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.