FAMILY HEALTH CENTERS OF SAN DIEGO, INC (NPI# 1477029205) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477029205 |
| Entity Type | Organization |
| Organization Name | FAMILY HEALTH CENTERS OF SAN DIEGO, INC |
| Other Organization Name | PACE-CENTER FOR OLDER ADULTS |
| Practice Address |
3420 College Ave San Diego CA 92115-7134 |
| Mailing Address |
823 Gateway Center Way San Diego CA 92102-4541 |
| Practice Telephone | 6195152445 |
| Practice Fax Number | 6192690545 |
| Mailing Telephone | 6195152300 |
| Mailing Fax Number | 6192371856 |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2019-05-29 |
| Authorized Official Name | RICARDO ROMAN (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6199064603 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251T00000X | PACE Provider Organization | Agencies |
| Other Name | Type Code |
|---|---|
| COLLEGE GROVE FAMILY HEALTH CENTER | Doing Business As Name - Organization |
| PACE-Center for Older Adults | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952925109 | Family Health Centers of San Diego, Inc | Clinic/Center | 333 H St Ste 2010, Chula Vista, CA 91910-5556 | 2020-06-03 |
| 1043856362 | Family Health Centers of San Diego, Inc | Clinic/Center | 1401 Imperial Ave, San Diego, CA 92101-7527 | 2019-11-21 |
| 1093298879 | Family Health Centers of San Diego, Inc | Clinic/Center | 3420 College Ave, San Diego, CA 92115-7134 | 2018-09-08 |
| 1891929691 | Family Health Centers of San Diego, Inc | Clinic/Center | 7586 Broadway, Lemon Grove, CA 91945-1604 | 2009-05-07 |
| 1174549232 | Family Health Centers of San Diego, Inc | Clinic/Center | 2391 Island Avenue, San Diego, CA 92102-2918 | 2006-07-14 |
| 1982635470 | Family Health Centers of San Diego, Inc | Clinic/Center | 1643 Logan Ave, San Diego, CA 92113-1004 | 2006-07-05 |
| 1386689701 | Family Health Centers of San Diego, Inc | Clinic/Center | 3705 Mission Blvd, San Diego, CA 92109-7104 | 2006-06-19 |
| 1508801069 | Family Health Centers of San Diego, Inc | Clinic/Center | 8788 Jamacha Rd, Spring Valley, CA 91977-4035 | 2006-06-18 |
| 1104861681 | Family Health Centers of San Diego, Inc | Clinic/Center | 1111 W Chase Ave, El Cajon, CA 92020-5710 | 2006-06-18 |
| 1013952597 | Family Health Centers of San Diego, Inc | Clinic/Center | 2204 National Ave, San Diego, CA 92113-3615 | 2006-06-18 |
| Street Address |
3420 COLLEGE AVE |
| City | SAN DIEGO |
| State | CA |
| Zip Code | 92115-7134 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093298879 | Family Health Centers of San Diego, Inc | Clinic/Center | 3420 College Ave, San Diego, CA 92115-7134 | 2018-09-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790313922 | Mayra Ailed Bugarin | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center 5454, El Cajon Blvd, San Diego, CA 92115 | 2020-04-01 |
| 1093369878 | Chang Liu | Counselor | 3539 College Avenue, San Diego, CA 92115 | 2019-07-30 |
| 1689238560 | Donia Ahadian | Student in an Organized Health Care Education/Training Program | City Heights Family Health Center, 5454 El Cajon Blvd, San Diego, CA 92115 | 2019-04-26 |
| 1780157859 | James Michael Sites | Military Health Care Provider | Uss Shoup Ddg 86, San Diego, CA 92115 | 2019-01-10 |
| 1780163006 | Marcos Luis Sandoval | Case Manager/Care Coordinator | 6224 El Cajon Blvd, Suite 17, San Diego, CA 92115 | 2018-08-08 |
| 1437651981 | Phyllis Lynette Pryor | Licensed Vocational Nurse | 4974 El Cajon Blvd Suite A, San Diego, CA 92115 | 2018-03-01 |
| 1982125605 | Ellen Medical Transport | Non-emergency Medical Transport (VAN) | 4587 Winona Ave #5, San Diego, CA 92115 | 2017-07-03 |
| 1992225296 | P'okot LLC | Non-emergency Medical Transport (VAN) | 5511 Adelaide Ave, 26, San Diego, CA 92115 | 2017-06-27 |
| 1578019840 | Alfred Zygmunt Nowak | Specialist/Technologist | 6663 Reservoir Ln, San Diego, CA 92115 | 2016-08-28 |
| 1639534183 | Kalkaal Financial Enterprise, LLC. | Non-emergency Medical Transport (VAN) | 5055 Collwood Blvd., Unit 108, San Diego, CA 92115 | 2015-12-29 |
| Find all providers in zip 92115 | ||||
| Taxonomy Code | 251T00000X |
| Grouping | Agencies |
| Classification | PACE Provider Organization |
| A PACE provider organization is a not-for-profit private or public entity that is primarily engaged in providing PACE services(unique capitated managed care benefits for the frail elderly which include comprehensive medical and social services). The following characteristics also apply to a PACE organization. It must: have a governing board that includes community representation; be able to provide complete PACE services regardless of frequency or duration of services; have a physical site to provide adult day services; have a defined service area; have safeguards against conflict of interest; have demonstrated fiscal soundness and have a formal Participant Bill of Rights. |
| Notes: Source: Centers for Medicare and Medicaid, PACE Fact Sheet http://www.cms.hhs.gov/PACE/Downloads/PACEFactSheet.pdf [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871191932 | One Family Health Enterprise | PACE Provider Organization | 206 E 185th St, Carson, CA 90746-1706 | 2020-10-12 |
| 1003445073 | North East Medical Services | PACE Provider Organization | 728 Pacific Ave Ste 201, San Francisco, CA 94133-4449 | 2020-04-02 |
| 1508422775 | Tri Starr Home Care LLC | PACE Provider Organization | 1669 Flanigan Dr., Unit H, San Jose, CA 95121 | 2019-05-14 |
| 1669037362 | Medrev | PACE Provider Organization | 558 Chelsea Way, Corona, CA 92879-5880 | 2019-05-08 |
| 1164980439 | Tri Starr Home Care, LLC | PACE Provider Organization | 1609 Flanigan Dr., Unit H, Unit H, San Jose, CA 95122 | 2019-03-06 |
| 1063988384 | Sequoia Pace, LLC. | PACE Provider Organization | 1649 Van Ness Ave, Fresno, CA 93721-1128 | 2018-10-15 |
| 1457838955 | La Coast Pace, LLC | PACE Provider Organization | 1220 E 4th St, Long Beach, CA 90802-1831 | 2018-07-26 |
| 1194202697 | Pacific Pace, LLC | PACE Provider Organization | 50 Alessandro Pl Ste A20, Pasadena, CA 91105-3149 | 2018-07-26 |
| 1356830947 | Stockton Pace | PACE Provider Organization | 582 E. Harding Way, Stockton, CA 95204 | 2018-05-09 |
| 1063901767 | Humboldt Mobile Massage, Inc | PACE Provider Organization | 1737 Margaret Ln, Arcata, CA 95521-6838 | 2018-05-08 |
| Find all providers with the same taxonomy | ||||
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| 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.