IMPERIAL BEACH HEALTH CENTER – NPI #1790718351
Clinic/Center

IMPERIAL BEACH HEALTH CENTER is an AHC clinic located in IMPERIAL BEACH, CA. NPPES has assigned the NPI number 1790718351 to IMPERIAL BEACH HEALTH CENTER on July 08, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “IMPERIAL BEACH HEALTH CENTER” is a dba name, the actual legal business name for this organization is IMPERIAL BEACH COMMUNITY CLINIC. The primary taxonomy selected by this provider is 261QC1500X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Community Health

The NPI profile was previously updated about 16 years ago on May 27, 2010. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for IMPERIAL BEACH HEALTH CENTER below.

NPI Profile for
IMPERIAL BEACH COMMUNITY CLINIC

NPI Number
1790718351
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
IMPERIAL BEACH COMMUNITY CLINIC
Doing Business As (dba): IMPERIAL BEACH HEALTH CENTER
Primary location
949 PALM AVENUE
IMPERIAL BEACH, CA 91932-1503
Phone: (619) 429-3733 Fax: (619) 429-6457
Mailing address
PO BOX 459
IMPERIAL BEACH, CA 91933-0459
Phone: (619) 429-3733 Fax: (619) 429-6457
Organization Subpart
No
Authorized Official
CONSTANCE KIRK
EXECUTIVE DIRECTOR
Phone: (619) 429-5387
Updated
Identifiers

Identifiers for IMPERIAL BEACH HEALTH CENTER

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

See identifiers
DescriptionIssuerStateIdentifier
OTHERCDPCABCP11826F
OTHERCOUNTY MEDICAL SERVICESCA40
OTHEREAPCCAEAP11826F
OTHERFAMILY PACTCAHAP11826F
OTHERLABORATORY CLIA NUMBER05D0683042
OTHERMEDI CALCAFHC11826F
MEDICAIDCAFHC11826F
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
261QC1500X
- Clinic/Center / Community Health (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.