Provider Demographics
NPI:1477207900
Name:THE STEVEN A. COHEN MILITARY FAMILY CLINIC AT VVSD, OCEANSIDE
Entity Type:Organization
Organization Name:THE STEVEN A. COHEN MILITARY FAMILY CLINIC AT VVSD, OCEANSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:AKILAH
Authorized Official - Middle Name:
Authorized Official - Last Name:TEMPLETON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-399-3124
Mailing Address - Street 1:3609 OCEAN RANCH BLVD STE 120
Mailing Address - Street 2:
Mailing Address - City:OCEANSIDE
Mailing Address - State:CA
Mailing Address - Zip Code:92056-2700
Mailing Address - Country:US
Mailing Address - Phone:619-345-4611
Mailing Address - Fax:
Practice Address - Street 1:3609 OCEAN RANCH BLVD STE 120
Practice Address - Street 2:
Practice Address - City:OCEANSIDE
Practice Address - State:CA
Practice Address - Zip Code:92056-2700
Practice Address - Country:US
Practice Address - Phone:619-345-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:VIETNAM VETERANS OF SAN DIEGO
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-02-03
Last Update Date:2022-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)