Provider Demographics
NPI:1316609803
Name:COMPREHENSIVE COMMUNITY HEALTH CENTER
Entity type:Organization
Organization Name:COMPREHENSIVE COMMUNITY HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARSENIO
Authorized Official - Middle Name:INOCENCIO
Authorized Official - Last Name:JIMENEZ
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:619-483-6985
Mailing Address - Street 1:250 S. ORANGE ST.
Mailing Address - Street 2:STE. 2
Mailing Address - City:ESCONDIDO
Mailing Address - State:CA
Mailing Address - Zip Code:92025-4142
Mailing Address - Country:US
Mailing Address - Phone:619-483-6985
Mailing Address - Fax:
Practice Address - Street 1:250 S. ORANGE ST.
Practice Address - Street 2:STE. 2
Practice Address - City:ESCONDIDO
Practice Address - State:CA
Practice Address - Zip Code:92025-4142
Practice Address - Country:US
Practice Address - Phone:619-483-6985
Practice Address - Fax:760-294-4362
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:COMPREHENSIVE COMMUNITY HEALTH FOUNDATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2021-10-12
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty