IMPERIAL BEACH COMMUNITY CLINIC (NPI# 1215246996) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215246996 |
| Entity Type | Organization |
| Organization Name | IMPERIAL BEACH COMMUNITY CLINIC |
| Other Organization Name | NESTOR COMMUNITY HEALTH CENTER |
| Practice Address |
1016 Outer Rd San Diego CA 92154-1351 |
| Mailing Address |
Po Box 459 Imperial Beach CA 91933-0459 |
| Practice Telephone | 6194293733 |
| Practice Fax Number | 6194296457 |
| Mailing Telephone | 6194293733 |
| Mailing Fax Number | 6194296457 |
| Enumeration Date | 2010-09-29 |
| Last Update Date | 2010-09-29 |
| Authorized Official Name | CONSTANCE KIRK (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6194295387 |
| Is Organization Subpart | Y |
| Parent Organization Name | IMPERIAL BEACH COMMUNITY CLINIC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Nestor Community Health Center | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790718351 | Imperial Beach Community Clinic | Clinic/Center | 949 Palm Avenue, Imperial Beach, CA 91932-1503 | 2006-07-08 |
| 1508028200 | Imperial Beach Community Clinic | Family Medicine | 949 Palm Avenue, Imperial Beach, CA 91932-1503 | 2008-06-25 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Oregon Corporations, Companies and Business Names | IMPERIAL BEACH COMMUNITY CLINIC | 949 Palm Ave, Imperial Beach, CA 91932 |
| Street Address |
1016 OUTER RD |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92154-1351 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801015193 | L Joanne Mooney | Obstetrics & Gynecology | 1016 Outer Rd, San Diego, CA 92154-1351 | 2007-04-24 |
| 1336598184 | Sheeren Liao Masifi | Family Medicine | 1016 Outer Rd, San Diego, CA 92154-1351 | 2016-06-11 |
| 1922445485 | Anne Chmilewski | Family Medicine | 1016 Outer Rd, San Diego, CA 92154-1351 | 2013-05-23 |
| 1942590815 | Francine M Martinez | Psychologist | 1016 Outer Rd, San Diego, CA 92154-1351 | 2011-04-13 |
| 1609101997 | Carolyn Moss Martinez | Nurse Practitioner | 1016 Outer Rd, San Diego, CA 92154 | 2009-10-05 |
| 1124288873 | Courtney Summers | Family Medicine | 1016 Outer Rd, San Diego, CA 92154-1351 | 2008-06-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952922783 | Rosalie Ramos Gayares | Licensed Vocational Nurse | Del Sur Crisis Center, San Diego, CA 92154 | 2020-05-04 |
| 1720625791 | Michelle Lynn Mason | Counselor | 892 27th Street, San Diego, CA 92154 | 2019-12-09 |
| 1538604020 | Victor Luis Assid | Counselor | 3069 Camino Aleta, San Diego, CA 92154 | 2016-12-20 |
| 1710346275 | Abba Transportation Services LLC | Non-emergency Medical Transport (VAN) | 5640 Surfrider Way #255, San Diego, CA 92154 | 2016-02-12 |
| 1851788962 | Danielle D. Weisman | Psychologist | 9335 Airway Rd Ste 202, San Diego, CA 92154 | 2015-04-16 |
| 1215321955 | Carolina Gonzalez-garcia | Marriage & Family Therapist | 3085 Beyer Blvd Ste A103, San Diego, CA 92154 | 2015-03-19 |
| 1285042945 | Maricela Ochoa | Pharmacist | 710 Dennery Road, San Diego, CA 92154 | 2014-07-25 |
| 1376975300 | Shatori R Dearman | Social Worker | 5143 Bay Crest Ln, San Diego, CA 92154 | 2013-08-01 |
| 1912257940 | Bj's Trading LLC | Durable Medical Equipment & Medical Supplies | 9668 Heinrich Hertz Drive Suite G, San Diego, CA 92154 | 2012-09-18 |
| 1881997625 | Tywila Reeves Bivens | Nurse's Aide | 976 Picador Blvd, San Diego, CA 92154 | 2010-12-17 |
| Find all providers in zip 92154 | ||||
| Taxonomy Code | 261QC1500X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326696329 | Uchechukwu Nkiru Dijeh | Clinic/Center | 5203 Caminito Cachorro, San Diego, CA 92105-5357 | 2019-09-03 |
| 1710236120 | Operation Samahan, Inc. | Clinic/Center | 9955 F2 Carmel Mountain Rd., San Diego, CA 92129-2815 | 2012-08-30 |
| 1932338241 | El Dorado Community Service Center | Clinic/Center | 1733 Euclid Ave, San Diego, CA 92105-5414 | 2009-07-08 |
| 1831383637 | Planned Parenthood Pacific Southwest | Clinic/Center | 4305 University Ave Ste 350, San Diego, CA 92105-8602 | 2007-09-05 |
| 1841225836 | Planned Parenthood Pacific Southwest | Clinic/Center | 1602 Thomas Ave, San Diego, CA 92109-4423 | 2006-07-11 |
| 1689609679 | Planned Parenthood of The Pacific Southwest | Clinic/Center | 2017 1st Ave Ste 301, San Diego, CA 92101-2033 | 2006-07-11 |
| 1245265230 | Planned Parenthood of The Pacific Southwest | Clinic/Center | 220 Euclid Ave Ste 30, San Diego, CA 92114-3617 | 2006-07-11 |
| 1124053111 | Planned Parenthood Pacific Southwest | Clinic/Center | 10717 Camino Ruiz Ste 258, San Diego, CA 92126-2364 | 2006-07-11 |
| 1306871397 | Planned Parenthood Pacific Southwest | Clinic/Center | 7526 Clairemont Mesa Blvd, San Diego, CA 92111-1504 | 2006-07-11 |
| 1215962204 | Planned Parenthood Pacific Southwest | Clinic/Center | 4501 Mission Bay Dr # 1c D, San Diego, CA 92109-4923 | 2006-07-11 |
| Find all providers in SAN DIEGO | ||||
Please comment or provide details below to improve the information on IMPERIAL BEACH COMMUNITY CLINIC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.