Provider Demographics
NPI:1407031693
Name:NEIGHBORHOOD HEALTHCARE
Entity Type:Organization
Organization Name:NEIGHBORHOOD HEALTHCARE
Other - Org Name:NEIGHBORHOOD HEALTHCARE - VALLEY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:RAKESK
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD,MBA,FAAFP,CPE
Authorized Official - Phone:760-520-8300
Mailing Address - Street 1:425 N DATE ST
Mailing Address - Street 2:
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-3413
Mailing Address - Country:US
Mailing Address - Phone:760-737-2035
Mailing Address - Fax:760-520-8314
Practice Address - Street 1:28477 LIZARD ROCKS RD
Practice Address - Street 2:
Practice Address - City:VALLEY CENTER
Practice Address - State:CA
Practice Address - Zip Code:92082-6206
Practice Address - Country:US
Practice Address - Phone:760-742-9919
Practice Address - Fax:760-742-9923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-07
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)Group - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW14158Medicare PIN
CA551103Medicare Oscar/Certification
CADA5215Medicare PIN