Provider Demographics
NPI:1871680397
Name:OPERATION SAMAHAN, INC.
Entity Type:Organization
Organization Name:OPERATION SAMAHAN, INC.
Other - Org Name:SAMAHAN HEALTH CENTERS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ARCHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BELLA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-986-9228
Mailing Address - Street 1:10737 CAMINO RUIZ
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92126-2359
Mailing Address - Country:US
Mailing Address - Phone:858-578-4220
Mailing Address - Fax:858-578-4417
Practice Address - Street 1:10737 CAMINO RUIZ
Practice Address - Street 2:SUITE 235
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92126-2359
Practice Address - Country:US
Practice Address - Phone:858-578-4220
Practice Address - Fax:858-578-4417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-06
Last Update Date:2022-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA080000146261QF0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEAP70250FOtherMEDICAID
CAW9341AOtherMEDICARE GROUP PROVIDER
CAEAP12036FOtherMEDICAID
CAZZT12036FOtherMEDICAID
CA64OtherCOUNTY MEDICAL SERVICES
CAFHC12036FOtherMEDICAID
CAZZT12036FOtherMEDICAID
CAW9341AOtherMEDICARE GROUP PROVIDER
CAEAP70250FOtherMEDICAID