Organization · Type 2 NPI

Venice Family Clinic

Federally Qualified Health Center (FQHC) · Los Angeles, CA

NPI number 1790156917 Active

Practice location

4700 Inglewood Blvd, Suite # 101
Los Angeles, CA 90230-5896

Call (310) 392-8636 Map

Fax (310) 664-7913

Mailing address

604 Rose Ave
Venice, CA 90291-2767

Specialties and licenses

Taxonomy	Code	License
Case Manager/Care Coordinator	171M00000X	None listed
Community Health Clinic/Center	261QC1500X	None listed
Federally Qualified Health Center (FQHC) Primary	261QF0400X	None listed

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

5 other providers at this address

Venice Family ClinicFederally Qualified Health Center (FQHC) Culver City, CA NPI 1003842360
Venice Family ClinicFederally Qualified Health Center (FQHC) Culver City, CA NPI 1992966782
Lisa MooreFamily Medicine Physician Culver City, CA NPI 1063827343
Mary Helen Smith, F.N.P.Community Health Registered Nurse Culver City, CA NPI 1649373200
Zarin Nasir Tejani, MDPediatrics Physician Culver City, CA NPI 1396906152

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NPI record

NPI: 1790156917
Entity type: Organization (Type 2)
Issued: Oct 14, 2015
Last updated: Sep 11, 2023
Status: Active
Subpart: Yes of Venice Family Clinic

Other names

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Lou Colen Health & Wellness Center · 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 1790156917

Venice Family Clinic's National Provider Identifier is 1790156917, issued on Oct 14, 2015. The primary taxonomy on file is Federally Qualified Health Center (FQHC) (261QF0400X), and the practice location is in Los Angeles, CA. The record was last updated on Sep 11, 2023.