Provider Demographics
NPI:1902388424
Name:CENTER FOR FAMILY HEALTH & EDUCATION INC
Entity Type:Organization
Organization Name:CENTER FOR FAMILY HEALTH & EDUCATION INC
Other - Org Name:PRIORITY CARE MEDICAL GROUP-LONG BEACH 2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CAO
Authorized Official - Prefix:
Authorized Official - First Name:MARISOL
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMIREZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:818-899-5555
Mailing Address - Street 1:6609 VAN NUYS BLVD STE 201-A
Mailing Address - Street 2:
Mailing Address - City:VAN NUYS
Mailing Address - State:CA
Mailing Address - Zip Code:91405-4618
Mailing Address - Country:US
Mailing Address - Phone:818-899-5555
Mailing Address - Fax:818-899-5969
Practice Address - Street 1:306 E PACIFIC COAST HWY STE 101
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90806-6259
Practice Address - Country:US
Practice Address - Phone:562-477-3500
Practice Address - Fax:562-270-3500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-31
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
No261QC1500XAmbulatory Health Care FacilitiesClinic/CenterCommunity Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA66698Medicaid