Organization · Type 2 NPI

Venice Family Clinic

Federally Qualified Health Center (FQHC) · Venice, CA

NPI number 1780462598 Active

Practice location

622 Rose Ave
Venice, CA 90291-2767

Call (310) 392-8636 Map

Mailing address

604 Rose Ave
Venice, CA 90291-2767

Specialties and licenses

Taxonomy	Code	License
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

Federally Qualified Health Center (FQHC): Definition to come...

3 other providers at this address

Venice Family ClinicFederally Qualified Health Center (FQHC) Venice, CA NPI 1114726148
Venice Family ClinicFederally Qualified Health Center (FQHC) Venice, CA NPI 1154187748
Joanna Isabel BurgaClinical Social Worker Venice, CA NPI 1245879337

Other federally qualified health center (fqhc) providers in Venice

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NPI record

NPI: 1780462598
Entity type: Organization (Type 2)
Issued: Sep 21, 2023
Last updated: Sep 21, 2023
Status: Active
Subpart: Yes of Venice Family Clinic

Other names

Venice Family Clinic - Mobile Clinic #3 · other name

Authorized official

Dr. Mitesh G Popat, MD
Chief Executive Officer
(310) 664-7901

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1780462598

Venice Family Clinic's National Provider Identifier is 1780462598, issued on Sep 21, 2023. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Venice, CA. The record was last updated on Sep 21, 2023.