Provider Demographics
NPI:1861933897
Name:OPERATION SAMAHAN INC
Entity type:Organization
Organization Name:OPERATION SAMAHAN INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF EXECUTIVE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:ARCHIE
Authorized Official - Middle Name:P
Authorized Official - Last Name:BELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:844-200-2426
Mailing Address - Street 1:1428 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NATIONAL CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91950-4624
Mailing Address - Country:US
Mailing Address - Phone:844-200-2426
Mailing Address - Fax:619-474-4008
Practice Address - Street 1:9855 ERMA RD
Practice Address - Street 2:SUITE 105 & 106
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-3001
Practice Address - Country:US
Practice Address - Phone:844-200-2426
Practice Address - Fax:858-578-4417
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:OPERATION SAMAHAN INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-03-09
Last Update Date:2025-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QF0400XAmbulatory Health Care FacilitiesClinic/CenterFederally Qualified Health Center (FQHC)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CABPSH80018226OtherHRSA